Agree and implement changes to the dialysis therapy
Overview
This standard is about agreeing and implementing changes to an individual's dialysis therapy. This may be due to under dialysis, the availability of new treatments or some aspect of the individual's lifestyle. Adjustments and compromises should concur with evidence for the overall benefits on individuals' wellbeing.
Users of this standard will need to communicate effectively to meet individuals' needs and wishes and work in line with health and safety legislation, policy and practices.
This activity could be carried out in a main dialysis unit, a satellite unit or the individual's own home.
Performance criteria
You must be able to:
P1. identify and agree the roles and responsibilities of yourself and others in agreeing and implementing changes to the dialysis therapy
P2. discuss with the individual and the multidisciplinary team possible changes in the plan of care to accommodate the individual's goals and aspirations without excessively compromising the individual's health or use of resources
P3. discuss with the individual and inform them of the risks and benefits of options and check that they understand the implications and what would be required of them
P4. identify and assess, in partnership with the individual and relevant others, the advantages and disadvantages of altering ongoing dialysis therapy, taking into account:
a. evidence of the effects on wellbeing of dialysis regimes
b. acceptability to individuals and
c. the needs of the unit
P5. negotiate any revised treatment plan with the individual and relevant members of the multidisciplinary team respecting individual confidentiality
P6. identify potential problems for the individual that may arise from their ability or preference to work with a revised treatment plan
P7. work with the individual to ensure they understand the revised plan.
P8. support the individual to act on the demands of the plan, including medication, dialysis times, self-measurement and recording requirements.
P9. agree the role and benefits of ongoing monitoring with the individual
P10. complete all relevant documentation required for dialysis therapy
Knowledge and Understanding
You need to know and understand:
K1. the current legislation, guidelines, policies, procedures and protocols which are relevant to your work practice and to which you must adhere
K2. the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
K3. how to access and interpret all relevant work instructions and information
K4. specific procedures for reporting issues which are beyond your competence, responsibilities and accountability
K5. the principles, practice and procedures associated with informed consent
K6. the procedures and methods relating to the coordination of inter-disciplinary and multi-disciplinary teams within and across services
K7. how to identify and respond to the concerns which individuals may have regarding dialysis and the way in which it affects their lives
K8. how to give feedback to the individual on the performance of dialysis
K9. the effects of dependence and independence on the individual, carer and the provision of the service
K10. how to obtain from individuals their goals, aspirations, feelings and expectations
K11. the importance of providing individuals with opportunities to ask questions and increase their understanding
K12. information that should be available in the plan of care, what it means
K13. how to make decisions from the multiple perspectives of a team
K14. the nature of renal failure and the function of renal replacement therapy
K15. how dialysis works for the individual and how its performance is measured
K16. the nature and significance of parameters of dialysis care plans
K17. evidence of the relationship between individuals' lifestyles and their wellbeing
K18. the relationship between dialysis, nutrition, medication and measures of the individual's health and procedures for controlling these
K19. how the individual can adapt the treatment to their personal needs and lifestyle without excessively compromising their treatment
K20. the organisation's policy on use of resources for individuals
K21. how to complete and safely store all relevant documentation in accordance with organisational requirements