Nursing assessment for dialysis patient

When you think of dialysis, you probably think of a patient with chronic kidney failure who attends a dialysis center two or three days a week. Yes, of course, but there is more to it than that.

In this article, we will explain in very simple terms what assessments nurses should be performing and their importance to patient care.

Why is dialysis nursing assessment important?

The dialysis nurse plays a critical role in providing quality patient care. Their vitality and importance undoubtedly contribute to optimal outcomes during and after treatment.

However, in order for their work to be more effective, critical thinking is needed to acquire and organize the necessary information during the assessment. It is true that many complications can be found/observed, but what will help in providing appropriate care? Undoubtedly, it will be the information gathered.

This is why it is so important – if the four steps are not followed, it will be difficult to get effective results.

How is a dialysis nursing assessment performed?

Assessment involves gathering information about the patient, family, and health status. Because the main purpose of assessment is to provide data, both for human response and pathophysiological response.

In this case, the dialysis nurse should perform the following steps to conduct the assessment:

  • Collection
  • Validation
  • Organization
  • Data reporting

It should be noted that this process must be performed continuously during the required activities with each patient.

Valuation method

  • Observation
  • Interview
  • Physical examination

Collection

Data collection is the systematic collection of data to determine the current status of an individual or group.

It is very important to have a model to serve as a guide so that the assessment can be clearly focused.

What guidelines should be considered for data collection?

  • Current or potential problems of the dialysis patient should be identified. This is obviously very important because based on the data collected and analyzed, decisions and interventions necessary for the patient can be made.
  • It is necessary to consider biopsychosocial aspects from a holistic point of view.
  • The patient’s responses must be collected based on their individuality.
  • The procedure should always be continuously evolving, i.e., to be effective, it should be reviewed if the data collected has not changed.

Types of data

  • Objective
  • Subjective
  • Historical
  • Current

As an aside, sources should be used either by the individual, family, physicians or nurses.

Important considerations when performing the collection

  • All information about the dialysis patient should be collected. But most importantly, it must be systematic and planned.
  • Problems and questionable aspects that the patient may present should be analyzed.
  • To perform a correct observation, experience and knowledge about dialysis will be needed.
  • Good communication and interaction with the patient is required to establish trust. This will allow the patient to receive information and participate effectively in their treatment.
  • Open questions should be asked clearly, with congruence between verbal and nonverbal communication, including respecting moments of silence.
  • Check the patient’s palpation, percussion, auscultation and inspection.

Data validation

Data validation is based on checking the data that have been collected by means of the selected guidelines.

It is of utmost importance to perform the verification in order to avoid misinterpretations at the moment of having any complication either with peritoneal dialysis or hemodialysis.

In order to prevent this from happening, the following should be avoided:

  • Precipitating conclusions.
  • Omitting relevant information.
  • Adequately interpret the situation.
  • Ensure that the information collected is complete.
  • Obtain additional information that may have been overlooked.
  • Ensure that the related objective and subjective data agree.

Organization

Once the data has been collected and verified, the next step is to continue with the organization and identification of patterns. At this stage it is essential to group the information in a coherent way in order to point out the real or potential problems of the dialysis patient.

Data Report

The data report is a support document for dialysis nurses for the purpose of recording the patient’s general condition. In addition, among the data that should be included in the report, the following can be pointed out:

  • Orientations performed to the dialysis patient
  • Observations on the patient to avoid future complications
  • General condition of the patient
  • Medications administered
  • Routine care and safety measures adopted

Conclusion

The assessment is very important, and if it is not done properly the rest will be affected. For this reason, the dialysis nurse must be quite rigorous when conducting the interview and finally the report of the data.

Following each of the stages of the assessment allows us to see the professionalism needed in dialysis nursing.