90989 Dialysis training, patient, including helper where applicable, any mode, completed course

Name of the Procedure:

Dialysis Training, Patient

Summary

Dialysis training equips patients (and helpers where applicable) with the knowledge and skills needed to perform dialysis at home. This can include any mode of dialysis such as hemodialysis or peritoneal dialysis. The course covers all aspects from preparation to performing the procedure safely and effectively.

Purpose

• Medical Condition: Chronic Kidney Disease (CKD) or End-Stage Renal Disease (ESRD) requiring dialysis.
• Goals: Enable patients to manage their dialysis independently, ensure they can safely and effectively perform the procedure, and improve their quality of life.

Indications

• Patients diagnosed with CKD or ESRD.
• Patients who are suitable candidates for home dialysis.
• Patients capable of handling the dialysis procedure or having a helper to assist.

Preparation

• Initial consultation with a nephrologist.
• Basic health evaluations and tests (blood work, urinalysis).
• Discussion of medical history and current medications.
• Instruction on adjusting diet and fluid intake.

Procedure Description

1. Initial Training: Overview of dialysis, its purpose, and different types.
2. Equipment Familiarization: Hands-on training with dialysis machines and necessary supplies.
3. Sterilization Techniques: Learning proper hand hygiene and sterilization to prevent infections.
4. Access Site Care: Instructions on how to care for the access site (fistula, graft, or catheter).
5. Dialysis Procedure: Step-by-step guidance on how to set up, initiate, monitor, and conclude the dialysis session.
6. Emergency Handling: Training on how to handle common issues or emergencies.
   • Tools/Equipment: Dialysis machine, catheters, exit site cleaning supplies, sterile gloves.
   • Anesthesia/Sedation: None typically required.

Duration

The training course typically spans several days to weeks, with each session lasting a few hours.

Setting

• Conducted in a specialized dialysis training facility or an outpatient clinic.

Personnel

• Nephrologists
• Dialysis nurses or educators
• Technicians

Risks and Complications

• Common Risks: Infection at the access site, low blood pressure, muscle cramps.
• Rare Risks: Blood clots, severe allergic reactions to dialysis solutions.
• Management: Patients and helpers are trained on recognizing and managing these complications.

Benefits

• Expected Benefits: Increased independence, improved quality of life, effective management of CKD.
• Realization Time: Benefits can be realized almost immediately after successful training completion.

Recovery

• Post-Procedure Care: Routine follow-ups with a nephrologist, regular blood tests.
• Recovery Time: No recovery time from the training itself; ongoing dialysis as prescribed.
• Restrictions: Adherence to dietary and fluid restrictions, maintaining cleanliness and care of the dialysis access site.

Alternatives

• In-center dialysis, if the patient cannot manage home dialysis.
• Pros: Professional supervision, no need for training.
• Cons: Less flexibility, more frequent travel to dialysis centers.

Patient Experience

• During Training: Patients may feel overwhelmed initially but generally adapt with practice and support.
• After Training: Patients typically gain confidence and feel more in control of their health. Pain is generally not associated with the training process, but comfort measures and support are provided.