Pre-dialysis education. A change in clinical practice. How effective is it?

The last decade has seen a great expansion in the provision of pre-dialysis education within the UK, with our programme in operation since 1996. In order to evaluate its impact on patient care, two methodologies were employed: the first used a satisfaction survey with which to examine patient perception of the programme; the second approach examined resource utilisation, in particular length of stay, as an outcome measure. Difficulties have arisen in discerning the impact of the programme amongst the other education interventions to which the patient is exposed. Comparative length of stay data was used as an alternative means of assessment. The results of the audit led us to question the effectiveness of the methodology that we employed and has led us to propose the development of a standard. It is hoped that the adoption of a more structured approach will not only aid the effectiveness of the programme itself but also facilitate the evaluation process.