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In-Center Self Care Hemodialysis

Research shows that dialysis patients who are actively involved in and take direct accountability for their care, generally experience and sustain improved clinical outcomes. By taking a more active role in your dialysis treatment, you may find that you are empowered and feel a renewed control over your life.

In-center self care hemodialysis is a program offered in many dialysis centers that makes it possible for you, and your care partner if you desire one, to take part in your dialysis treatment. In DaVita dialysis centers, you and/or your care partner may select to perform some or all of the treatment. Other dialysis centers may offer in-center self care hemodialysis, but could require you perform the complete treatment instead of some of the tasks. Before performing in-center self care, registered nurses and patient care technicians will teach and assist you in becoming competent on how to perform dialysis. After you have mastered your skills, you will perform the skill on your own, and because you are in a dialysis center, there will always be nurses and patient care technicians nearby. The health care professionals will be there to support you, answer your questions and lend a helping hand if you should need one.

Being involved in your dialysis care can be good for your health

Many patients believe dialysis is a medical procedure best left to health care professionals. However, studies have shown that dialysis patients who take an active role in their treatments tend to:

• have better clinical outcomes
• feel more in control of their lives
• build self esteem from providing their own care

Many people who have been diagnosed with a chronic illness report feeling that they are no longer in control of their life or their bodies. Dealing with the loss of kidney function can be overwhelming; however, those who become more active in their dialysis treatment say they feel more positive having regained more control of their lives.

In addition to learning more about kidney disease and performing hemodialysis, in-center self care dialysis patients tend to follow the advice of their health care team more closely than other patients regarding staying on dialysis the full time and maintaining their dialysis diet. These behaviors may help in-center self care patients achieve better clinical outcomes.

Dialysis skills patients can learn to perform

You and your care partner, if you want a partner, may not want to perform the entire treatment process, but there may be some skills that you would like to perform on your own. For this reason, DaVita In-Center Self Care lets you pick and choose from a variety of activities.

When doing in-center self care hemodialysis, you can learn how to:

• Weigh yourself — You will learn to weigh in before and after each treatment. The weigh-in before your treatment determines how much fluid weight you gained since your last treatment and the weigh-in after your treatment shows how much fluid was removed.
• Wash and hold your access site — You will learn to wash your access site before each treatment. Your access site must be washed before every dialysis treatment to minimize infection. After the treatment, you may choose to hold your access site. 
• Measure your vital signs — You will learn to take your pre-treatment and post-treatment vital signs. Additionally, if you are interested, you may want to take your vital signs every 30 minutes during your treatment to make sure they are within normal range.
• Administer select medications — You will learn to draw up and/or administer select treatment medications. Medications are administered during your dialysis treatment to keep your blood from clotting and to help your treatment run smoothly. You will also learn more about your treatment medications.
• Set up your machine — You will learn how to set up your dialysis machine prior to your treatment. Your dialysis machine needs to be set up before each treatment and programmed to your settings to ensure you get an adequate treatment. You may also learn how to strip and clean the machine after your treatment.
• Collect your lab specimens — You may learn how to collect lab specimens before your treatment and after your treatment depending on your lab draw schedule. Lab specimens are taken so your health care team can assess how well the dialysis is cleaning your blood.
• Self-cannulate — You will learn how to insert your dialysis needles or cannulate. Two needles must be inserted into your vascular access before your dialysis treatments so that your blood can flow to and from the dialysis machine. You may also learn how to remove your needles at the end of your dialysis treatment. 

Most patients can perform all of these skills alone or with the help of their care partner; however, some patients would rather have a health care professional be responsible for some of the skills. Many patients who wish to do home hemodialysis (HHD) start by performing in-center self care.

In-center self care hemodialysis training

Training for in-center self care takes place at your dialysis center, sometimes in a separate room dedicated to self care. At the beginning of your training, you will simply watch and listen while your training nurse or patient care technician explains each process. If you have been doing in-center hemodialysis treatments, you will already be familiar with the hemodialysis process. As you learn each skill, you will be able to perform that skill yourself.

The time that it takes to learn each skill varies depending on how quickly you learn. It could take only a couple weeks to learn the skills or it could take a couple months. There is no rush and no deadline to learn the skills for in-center self care hemodialysis. Some patients slowly build up skills over time as they gain confidence and experience.

Is in-center self care hemodialysis right for you?

The single most important factor in deciding if in-center self care hemodialysis is right for you is whether or not you have the desire to learn. If you want to learn, your in-center self care team can work with you to teach you the skills necessary to take part in your hemodialysis treatments.

It is also helpful if you have a vascular access that functions well, basic manual dexterity, adequate vision and a positive attitude when it comes to taking direction from your training team.

Summary

Whether you want to use in-center self care hemodialysis as a training program to transition to home hemodialysis or wish to take part in some of your dialysis treatment in the center, talk to your nurse to find out more about in-center self care.