Dialysis Tasks
Under our collection for tasks we collect hemodialysis and peritoneal dialysis. Since the directions are largely the same, this article contains instructions for both.
Only mark a task as performed if it was done during a patients stay on your ward. If a task was done prior to patient coming to your ward or after patient is transferred to another ward, it should be marked as no or none during the stay on your ward.
Dialysis
Hemodialysis Task
- possible entries: (none, acute, chronic)
- Acute – first time dialysis ever happened during this hospital admission
- Chronic - dialysis which was being done on an outpatient basis prior to this hospitalization
Peritoneal Dialysis Task
- possible entries: (none, acute, chronic)
- Acute – first time peritoneal dialysis ever happened during this hospital admission
- Chronic - dialysis which was being done on an outpatient basis prior to this hospitalization or patient was doing on their own at home prior to this hospitalization
Peritoneal vs Hemodialysis
The two are not mutually exclusive, if both happen while the patient is on the ward, code both.
Acute vs Chronic
If a patient has both chronic and acute dialysis during the same admission (e.g. after a transplant), then code the acute dialysis.
Short stay patients
Not all pts with DX of ARF or CRF in comorbids have their dialysis during ward admission, particularly if they are a short stay (less than 4 days).
Discussion - Nr of days
Template:Discussion In Check Renal Tasks we say 3 days. Is it 4 or 3? Ttenbergen 11:44, 30 September 2009 (CDT)
Dialysis outside the unit
Pt is sent to other wards for their dialysis, therefore it may be correct that there might not be a dialysis acute or chronic TASK is marked. In ! Automated Data Integrity Checks I read: "If Grace and VIC Med send patient for dialysis to HSC or STB, then they return back to medicine bed, TASK will be marked with dialysis for their site." I think Trish wrote it. If this is true, it needs to be included here. Ttenbergen 17:16, 27 October 2008 (CDT)
Discussion - Dialysis on other wards
Template:Discussion If a patient is sent to another ward for dialysis, should this be coded on this ward or not? How will this data be used?Ttenbergen 11:48, 30 September 2009 (CDT)
Dialysis after transplant
If CRF is coded as per instructions (i.e. don't code CRF for patients with a working kidney transplant) then these patients will not be flagged for missing tasks.
Patients who have underlying CRF are on chronic hemodialysis or peritoneal dialysis, if they go for a kidney transplant and develop a complication of rejection, hyper K+ or renal failure etc., post kidney transplant and subsequently require dialysis, this will be considered acute dialysis.
Dialysis Examples
Example 1:
- I have a patient that was admitted to my floor from another medical floor. The patient was a chronic h.d. patient prior to admisssion. A week or two after admission (while still on the first medical floor), the patient was switched to p.d. For my admission I put h.d. chronic, and p.d. acute. This patient has now switched back and forth between h.d., and p.d. on an almost weekly basis. How do I code the dialysis tasks now that she has gone back and forth with both?--DPageNewton 15:55, 15 October 2008 (CDT)
- HD Chronic & PD Acute or not mutally exclusive therefore you can mark both in TASKS if both are occurring while patient is on your ward.--TOstryzniuk 00:40, 19 November 2008 (CST)
Example 2:
- Patient came from ER with CRF and was receiving outpatient peritoneal dialysis (PD). Pt developed shock and was sent to ICU where he had Hemodialysis. On your ward the pt had peritoneal dialysis done once before going to ICU.
- You would mark CHRONIC PD as a TASK. You would not mark ACUTE HD. This is being done during his ICU stay.
Example 3:
- Pt came from ER to your ward with CRF (on outpatient PD dialysis). Pt had to be switched to hemodialysis because of peritonitis.
- Peritoneal dialysis should be marked chronic if patient had peritoneal dialysis done one or more times while on your ward. Switched to hemodialysis which is new and should therefore be marked as acute.
Example 4:
- An ICU patient with ARF receiving acute hemodialysis in ICU, comes to your ward from the ICU and expires within a day or two. No dialysis was ever done for the short time patient was on your ward.
- The hemodialysis task should be marked as none.