Ward control alignment for Patient's Anemia:
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Ward control alignment for Patient's Anemia: Planning, constructing, staff-training, implementation and follow-up. Ronice Wagner 1 Igor Semhaev 1 Department of Nephrology and Hypertension, Rabin Medical Center, Beilinson Hospital, Israel 1. Background.

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Ronice wagner 1 igor semhaev 1

Ward control alignment for Patient's Anemia: Planning, constructing, staff-training, implementation and follow-up.

Ronice Wagner1 Igor Semhaev1

Department of Nephrology and Hypertension, Rabin Medical Center, Beilinson Hospital, Israel 1


Background
Background

Erythropoietin is a glycoprotein hormone that controls and regulates red blood cell production. It is produced and secreted in the kidney. Chronic renal failure is associated with various degrees of anemia due to erythropoietin deficiency resulting from multiple factors


Among those factors we find
Among those factors we find -

  • Decreased erythropoietin production as a result of kidney damage.

  • Decreased RBC lifespan secondary to uremia.

  • Reduced bone marrow response to circulating erythropoietin.

  • Ongoing blood losses from dialyzer and tubing, blood sampling, gastrointestinal blood loss, and blood losses at the time of dialysis needle placement and removal.

  • Depletion of iron stores precedes impaired production of iron-containing proteins, the most prominent of which is hemoglobin


The mainstay anemia treatment includes administration of i v erythropoietin and iron
The mainstay Anemia treatment includes Administration of I.V Erythropoietin and Iron. .

  • Till the end of 2009 our patients received monthly prescriptions for medications and were required to purchase them personally.

    The reasons that this procedure was never smooth and effective were :

  • Physician’s decisions were based on narrow scope of data.

  • Delays in delivering reports to the physicians.

  • Patients were unreliable in purchasing and delivering medications on-time.


Objective
Objective Erythropoietin and Iron.

In order to reduce the burden and relieve the patients from this tedious procedure we decided to make the ward responsible for the monthly drug supply.


Method
Method - Erythropoietin and Iron.

On December 2009 a new role was established :

Anemia Coordinator


Ronice wagner 1 igor semhaev 1
Anemia Coordinator’s duties included Erythropoietin and Iron. –1 - Creating a ward monthly tabledisplaying blood tests and present prescribed treatment


Ronice wagner 1 igor semhaev 1

2 - Creating a monthly Erythropoietin and Iron. personal physicians’ tabledisplaying his/hers patient blood tests results and present medical treatment leaving empty space forchanges.


3 building a summing up order form for ward medication supply
3 - Building a Erythropoietin and Iron. summing-up order formfor ward medication supply.


Ronice wagner 1 igor semhaev 1
) Erythropoietin and Iron.

Create a registration formwhich checks indicates and updates the expiring dates of drug supply confirmation, given by the Central Pharmacy:

Ronice 2011


Anemia coordinator monthly duties are
Anemia coordinator Erythropoietin and Iron. monthly duties are -

1. Fill in the new Laboratory Results in the Monthly table , Personal physicians’ table and Ward Medication Supply List .

2. Give every physician his personal patients list. Get new medical orders and add them to the patient's files.

3.Send the corrected Ward Medication Monthly Supply Listto the Central Pharmacy

4.Upon medical supply arrivel, storeit according to the hospital and medical regulations.

5. Give proper instructions and guidanceto the ward team.


Mean hb levels during activity period of anemia coordinator n 100 110
Mean Erythropoietin and Iron. Hb levels during activity period of Anemia Coordinator (n=100 - 110)

Since appointing an Anemia

Coordinator we have observed –

1.Improved stability in ward Hemoglobin.



3 significant reduction in number of blood transfusions
- Erythropoietin and Iron. 3.Significant reduction in number of blood transfusions


Conclusions and recommendations
Conclusions and Recommendations Erythropoietin and Iron.

Observing the positive results of the new method we recommend other units to implement this management concept

in order to improve

Anemia Alignment.


Ronice wagner 1 igor semhaev 1

לכל Erythropoietin and Iron. המעוניינ/ת בטבלאות המצורפות

מוזמנ/ת לפנות במייל:

ronisv@clalit.org.il

ronisvagner@gmail.com