IMPROVING PATIENT ENGAGEMENT AND QUALITY OF CARE FOR INDIGENOUS HAEMODIALYSIS PATIENTS THROUGH OUTREACH PROGRAM
Mrs Archana Khadka Shapkota1, Prof. Sandwana William Majoni1, A/Prof. Jane Davies1, Jaclyn Tate-Barker1, Stephanie Long1, Jane Nelson1
1Menzies School Of Health Research, Tiwi, Australia
Background: Significant proportion of Indigenous patients receiving haemodialysis in the Northern Territory live in remote and rural communities. Due to the lack of dialysis services in remote communities, patients are often required to permanently relocate to urban areas for treatment, which causes disconnection from country, culture, and social support network. The physical and psychosocial demands of haemodialysis profoundly affect Indigenous patients’ ability to access and attend specialist services. Barriers to accessing services include lack of cultural support, patient distrust in hospital system, language barriers. Hence, these patients have a higher number of cancellations and non-attendance at appointments.
Aim: This study aims to improve patient engagement and quality of care for Indigenous haemodialysis patient living with liver cirrhosis through hepatology/renal outreach program.
Method: Fibroscan (liver elastography) was used to measure the liver stiffness in Indigenous haemodialysis patients. 64 out of 250 (25.6%) patients had results consistent with liver cirrhosis. Haemodialysis patients with cirrhosis have poor prognosis and low survival rate. Hence, hepatology/renal outreach model was developed, where a Nurse Practitioner (NP) will review the patients in respective renal units along with a sonographer to conduct abdomen ultrasound.
Results: Patients were comfortable to be reviewed in a familiar environment and fully engaged with the clinicians. The number of non-attendance was significantly low. Patients were followed up in a timely manner. Clinicians were able to identify anyone with urgent medical concerns and notify the consultant nephrologist to promptly plan the necessary actions.
Conclusion: Outreach model of care facilitates patient engagement, increases patient satisfaction and promotes effective rapport to improve quality of care. Timely follow-up of liver cirrhosis reduces the risk of developing liver-related complications in Indigenous haemodialysis patients.
Biography:
Archana is a registered nurse currently working at Menzies School of Health Research as a research nurse for INFERR clinical trial. Archana holds a Graduate Diploma of Public Health and is in her final year of Master of Public Health/Master of Health Research double degree. Archana has extensive knowledge and experience working closely with Indigenous patients living with complex healthcare needs. Indigenous patients face inconceivable challenges when it comes to accessing health care. Archana aspire to work towards the health care advancement for Indigenous haemodialysis patients by making specialist care more accessible.