Developing a haemodialysis acuity tool (the HAT study): A qualitative study

Josephine S F Chow; Susana S Miguel; Glenda Rayment; Nutan Maurya

doi:10.1111/jorc.12485

Developing a haemodialysis acuity tool (the HAT study): A qualitative study

J Ren Care. 2024 Jan 21. doi: 10.1111/jorc.12485. Online ahead of print.

Authors

Josephine S F Chow^{1

2

3

4

5}, Susana S Miguel¹, Glenda Rayment⁶, Nutan Maurya¹

Affiliations

¹ South Western Sydney Nursing & Midwifery Research Alliance, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.
² Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia.
³ Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁴ NICM Health Research Institute, Western Sydney University, New South Wales, Australia.
⁵ Faculty of Nursing, University of Tasmania, Hobart, Tasmania, Australia.
⁶ Renal Unit, Liverpool Hospital, Liverpool, New South Wales, Australia.

PMID: 38245848
DOI: 10.1111/jorc.12485

Abstract

Background: Haemodialysis units are now managing an increasing number of patients with varying needs and levels of acuity. To maintain safety, haemodialysis patients must be placed in the most appropriate dialysis unit that has the required human and physical resources to care for them. The first step towards achieving these goals is to develop a tool specific to haemodialysis units to effectively measure patient acuity.

Objective: To develop a haemodialysis acuity tool, utilising a focus group approach, in assessing patient's suitability for a specific dialysis location thus ensuring patient safety.

Design: This is a cross-sectional qualitative study via a focus group approach.

Participants: Participants were nurse unit managers and team leaders of a District Renal Service.

Approach: Participants were interviewed to explore their views on the elements and measures identified in the research aims. Themes for interviews were informed by current literature on acuity tools for haemodialysis patients' admission to the dialysis units. Interviews were recorded and transcribed verbatim and progressively analysed using a thematic analysis approach.

Results: Ten nurse unit managers/team leaders (100%) were interviewed and thematic analysis of the transcripts was conducted utilising the deductive approach. Five themes were identified which will form the main categories in the development of the tool, namely: Age/frailty; co-morbidity; physical; dialysis; and psychosocial.

Conclusion: This study is instrumental in the development of the haemodialysis acuity tool which can be used in allocating dialysis location specific to patient's needs and available resources. The tool can also be used in analysing patient care processes and resource requirements based on the patients' and unit's profile.

Keywords: acuity; dialysis; haemodialysis; measurement; tool.