Successful Home Hemodialysis Programs: An Exploration of Key Nursing Care Processes

The aim of this qualitative study was to identify nursing processes of care that help keep patients successfully on home hemodialysis (HHD). A qualitative descriptive approach using appreciative inquiry was used as the framework for data collection and analysis. Four focus groups were held with HHD nursing teams in the Province of Ontario, Canada. Results suggest that successful HHD teams have highly performing nurses who work cohesively as a team, and have consistent structures and processes in place for patient education and follow up. A culture of success has the potential to keep patients successfully on HHD, improve nurse job satisfaction, and retain highly functioning and specialized nursing staff. Quality improvement initiatives aimed at improving rates of HHD are important given the benefits to patients of HHD as a treatment modality.