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Continuous quality improvement: improving hemodialysis catheter patency using urokinase
1Hemodialysis unit, Department of Veterans Affairs Medical Center, Gainesville, FL, USA.
Insights
Continuous quality improvement (CQI) programs can enhance patient outcomes. A 2-year CQI program using urokinase successfully improved dialysis catheter patency rates, benefiting patients, staff, and program costs.
Area of Science:
- Nephrology
- Vascular Access
- Quality Improvement
Background:
- Vascular access outcomes remain a significant challenge for hemodialysis patients.
- Dialysis catheters are increasingly used as permanent vascular access, posing a risk of catheter occlusion.
- Catheter occlusion is a common complication affecting hemodialysis treatment efficacy.
Purpose of the Study:
- To implement and evaluate a 2-year continuous quality improvement (CQI) program.
- To improve dialysis catheter patency rates in hemodialysis patients.
- To assess the clinical, staff, and cost-effectiveness of the CQI program.
Main Methods:
- Development and implementation of a 2-year CQI program.
- Utilized urokinase to address dialysis catheter occlusion.
- Monitored clinical outcomes, patient and staff benefits, and cost-effectiveness.
Main Results:
- The CQI program demonstrated significant improvements in dialysis catheter patency.
- Observed beneficial clinical outcomes for hemodialysis patients.
- Reported positive impacts on dialysis staff and cost-effectiveness.
Conclusions:
- Applied CQI programs offer substantial opportunities for improving patient outcomes in nephrology.
- The implemented CQI program effectively enhanced dialysis catheter patency.
- The use of urokinase within a CQI framework proved beneficial and cost-effective.
Abstract:
Opportunities for improvements in patient outcomes through applied continuous quality improvement (CQI) programs are endless and exciting. Improving vascular access outcomes has been a long-standing clinical problem for hemodialysis patients and the nephrology team. During the past few years there has been a dramatic increase in the use of dialysis catheters as permanent accesses for hemodialysis patients. All hemodialysis with dialysis catheters are at risk for catheter occlusion. An innovative, 2-year CQI program was developed, implemented, and designed to improve dialysis catheter patency rates with the use of urokinase. The CQI program resulted in a number of clinical outcomes that were beneficial to the patients and dialysis staff, and were cost-effective to the program.