Evaluation of Efficacy of a Quality Improvement Haemodialysis Safety Checklist for Nursing Staff: A Comparative Analysis

Abstract

Haemodialysis is a life-sustaining procedure performed on patients with end-stage renal disease. However, it is not without risks and patient safety during haemodialysis is of utmost importance. This research study aims to evaluate the efficacy of a quality improvement Haemodialysis Safety Checklist in enhancing patient safety and improving the performance of nursing staff. A comparative analysis approach was employed to assess the impact of implementing the Haemodialysis Safety Checklist. The study involved two groups: an intervention group where the checklist was implemented and a control group where the checklist was not introduced. Patients’ health records were assessed then to check the frequency of complications/ serious events and deaths. The results of the study showed that the implementation of a checklist had a positive impact on compliance and safety during the dialysis procedure. Before dialysis, only one participant (0.1%) did not comply with thermometer reading, while the majority, 749 (99.9%), followed the protocol. Similarly, 5 participants (0.7%) did not undergo weight checks before dialysis, which decreased to four participants (0.5%) after checklist implementation. In terms of vital signs, 35 participants (4.7%) did not have them checked before dialysis, while only two participants (0.3%) skipped them post-dialysis. Adverse events were minimal, with most participants not experiencing hypoglycaemic or hypotensive episodes, complications at the access site, requiring Renal Replacement Therapy (RRT) or encountering Code Blue situations, blood loss, falls, or needle stick injuries. The introduction of the checklist reduced the percentage of participants not having their weight measured after dialysis from 6.7% to 0.4%, with a statistically significant chi-square value ( <0.001*). Similarly, the occurrence of cramps decreased from 99.7% to 98.9% after dialysis. These findings demonstrate the checklist’s effectiveness in improving compliance and reducing adverse events during dialysis.