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This study seeks to use a knowledge management (KM) model as a tool to improve the quality of service in a hemodialysis unit.

A quasi‐experimental, one group pre‐test‐post‐test study was conducted over a period of ten months at a hemodialysis unit. All of the staff in the unit, and all of the patients who came for hemodialysis at the outpatient department during the study period, were invited to participate. Self‐administered questionnaires were used to measure staff job satisfaction and patient satisfaction. SF‐36v2 was used to assess patient quality of life (QoL). Wilcoxon's matched pairs test and paired t‐test were used to compare staff job satisfaction, and patient satisfaction with service quality, before and after implementing KM. A within‐subject repeated‐measure analysis of variance (ANOVA) was used to assess changes in patient QoL. The chi‐square test was used to compare rates of hemodialysis complications before and after implementing KM.

After implementing KM, staff job satisfaction and patient satisfaction with services, increased significantly. Three QoL domains – role limitations due to physical and emotional problems, and vitality – at three and six months post‐intervention applying KM to daily work, had improved significantly. Complications per hemodialysis episode had also reduced.

The paper focuses on intervention that applied KM to staff providing care for patients with hemodialysis to improve care and outcomes.

The purpose of this study is to evaluate the nutritional status of patients with end-stage kidney disease undergoing hemodialysis.

End-stage renal failure outpatients on hemodialysis were selected using simple random sampling technique from the dialysis unit of Sono Hospital Limited, Kushtia, Bangladesh. The nutritional status of 142 participant, of age 18-65 years, was screened. A direct method of nutritional assessment including anthropometric measurement, biochemical measurement, clinical assessment and dietary method was conducted. A logistic regression was applied to estimate the prevalence of malnutrition in hemodialysis patients.

In total 69.0 per cent participants were men and 31.0 per cent were women, whereas about 65.5 and 16.9 per cent patients of this study had a BMI of less than 23 kg/m² and 18.5 kg/m² (p < 0.05) where malnutrition was significantly prevalent. Mean ± SD hemoglobin level of both men and women participants was below the normal level which might increase the risk of malnutrition (p < 0.05). Of the total number of participants, 97.2 per cent were anemic, 66.9 per cent had anorexia, 63.4 per cent complained of nausea, 58.5 per cent complained of vomiting and 26.1 per cent complained of diarrhea, factors that can increase the risk of malnutrition in hemodialysis patients (p < 0.05). The creatinine and urea levels were higher in both men and women participants (p < 0.05). Results show significant difference in albumin levels among men and women (p < 0.05). The bicarbonate level was lower in both men and women, and the participants were suffering from metabolic acidosis (p < 0.05). About 87.3 per cent participants were taking inadequate amounts of protein which was a significant risk factor of malnutrition in hemodialysis patients (p < 0.01).

The result shows that renal failure is prevalent more in men than in women. The majority of patients on hemodialysis were at a risk of malnutrition including being underweight. Most of the patients were anemic. Malnutrition is related to low nutrient intake.

This study aims to determine the effect of aromatherapy used in reducing the pain caused by fistula puncture in hemodialysis patients.

In this study, the effect of aromatherapy application on fistula puncture was analyzed and carried out by scanning the relevant literature. The literature review was conducted between August and October 2020. While reviewing the literature, the authors used “aromatherapy,” “pain,” “fistula,” “puncture,” “hemodialysis” keywords and various combinations of these; moreover, Google scientist, Pubmed, Cochrane, ScienceDirect, Web of Science, Medline and Ovid databases and studies, which were conducted in the last 10 years were reviewed. As a result of the literature review, 1183 studies were reached and seven of them were included in the study by taking the inclusion criteria into account.

The randomized controlled studies are six studies and nonrandomized controlled experimental 1 study were added to the scope of the study and seven studies were included in the sample. In these studies, personal information forms developed by the researchers as data collection tools and the VAS scale, Numerical pain rating, the numeric rating scale were used to evaluate pain.

It has been determined that aromatherapy application in hemodialysis patients has positive effects on reducing pain due to puncture fistula intervention.

This study provides reduction or elimination of fistula needle insertion pain in hemodialysis patients.

This study aims to evaluate the prevalence of depression and associated risk factors among patients on hemodialysis in Jazan area, Saudi Arabia.

The study was conducted on 211 randomly selected hemodialysis patients in Jazan area, Saudi Arabia, using an observational cross-sectional design. Patients were screened for depressive symptoms using the depression, anxiety and stress scale 42 (DASS-42). Descriptive statistics were used to present sociodemographic data. Multiple logistic regression was implemented to identify the predictors of depression. Data were entered and analyzed using SPSS 22.0 software.

The study found the overall prevalence of depression among patients on hemodialysis to be 43.6 per cent. Of them, 12.8 per cent were mildly depressed, 15.6 per cent were moderately depressed and 15.1 per cent fell in the severe or extremely severe category. Depression was significantly associated with marital status, education level and the presence of sleep disturbances. The study indicates a high prevalence of depressive symptoms among patients on hemodialysis in Jazan. A higher rate of depressive symptoms was observed in currently unmarried, lower-educated patients and those with sleep disturbance.

Periodic evaluation of patients on hemodialysis for depression is needed to allow for early intervention.

The quality of haemodialysis process is a prime concern in renal care. This study, carried out at one of the leading Hospitals in Central India, providing kidney care and dialysis, aims to identify areas in the haemodialysis unit needing special attention, to improve process quality and ensure better patient welfare.

The failure mode and effects analysis (FMEA) approach included: deciding haemodialysis process requirements, identifying potential causes of process failure and quantifying associated risk with every cause. Suitable actions were then implemented to reduce the occurrence and improving the controls, thereby reducing risk. The study used primary data generated and monitored over the period: July‐December 2008.

Adopting proper checklists for work monitoring, providing training to enhance patient and staff awareness; led to reduced process errors, mitigating overall risks, eventually resulting in effective patient care.

The quantification of risk associated with every likely failure is subjective.

The findings have a great significance in relation to kidney patients' welfare. The process areas which may get compromised are highlighted so that they get due attention. Error proofing makes the process “robust”, reducing its vulnerability.

This study provides a microscopic error proofing approach to haemodialysis process using a proven engineering tool, FMEA, ensuring quality improvement. This approach can also be extended to cover other hospital activities.

Hope and death anxiety as the important sources of adjustment can affect the attitude, health status and quality of life in patients undergoing hemodialysis. Hopelessness and death anxiety are considered as the important factors in patients undergoing hemodialysis, because these can avoid non-adherence and increase mortality rate. This study aims to investigate the effect of the cognitive–behavioral intervention on hope and death anxiety in patients undergoing hemodialysis.

In this randomized controlled clinical trial, 84 patients undergoing hemodialysis were included, who were then divided into two groups as the cognitive–behavioral intervention group (n = 42) and the control group (n = 42). The experimental group received eight sessions of individual chair-side cognitive–behavioral intervention. To measure the hope level and death anxiety, Hearth Hope Scale and Templer’s Death Anxiety Scale were used as tools once at the beginning and once at the end of the study.

The mean scores of the hope levels in the intervention group significantly improved compared to the control group. Furthermore, the mean scores of the death anxiety levels significantly decreased in the intervention group compared to the control group.

Cognitive–behavioral interventions are significantly effective on promoting the level of hope and decreasing the level of death anxiety in patients undergoing hemodialysis. Therefore, applying this psychological intervention to design the individual education programs is recommended.

This chapter attempts to clarify the underlying mechanisms of the relationship between socioeconomic status and health outcomes. Former studies of this relationship have largely focused on the materialist predictors of health outcomes, examining variables such as income, access to healthcare, or quality of housing. The current study, by contrast, looks at individuals’ behaviors and attitudes, particularly in relation to physicians, and their impact on the quality of care patients receive. Using data from a sample of 64 hemodialysis patients in a middle-class suburb of Long Island, I examined the effect of comfort and ease with doctors and willingness to engage them on patient compliance. The findings suggest that patients who are more comfortable asking their doctors how they feel, and those that push for more information in general, tend to be more compliant, and therefore enjoy better and more successful patient outcomes.

his research studies the effectiveness of different dialysis units on patients with renal failure by comparing the blood constituent before and after dialysis which indicates the dialyzer efficiency. Three kinds of hollow fiber materials were used in this research, Cuprophan, hemophan and polysulfone, with three surface areas of 1.1, 1.3, and 1.6 m². Different parameters were studied, including fiber type and surface area, to evaluate the efficiency of the dialyzers under study. Polysulfone dialyzers of 1.6 m² have achieved the best results compared to other types of dialyzers.

Nowadays, the risk assessment and reliability engineering of various production processes have become an inevitable necessity. Because if these risks are not going to be evaluated and no solution is going to be taken for their prevention, managing them would be really hard and costly in case of their occurrence. The importance of this issue is much higher in producing healthcare products due to their quality's direct impact on the health of individuals and society.

One of the most common approaches of risk assessment is the failure mode and effects analysis (FMEA), which is facing some limitations in practice. In this research, a new generalized multi-attribute failure mode analysis approach has been proposed by utilizing the best–worst method and linguistic 2-tuple representation in order to evaluate the production process of hemodialysis solution in a case of Tehran, Iran.

According to the results, entry of waste to the mixing tanker, impurity of raw materials and ingredients and fracture of the mixer screw have been identified as the most important potential failures. At last, the results of this research have been compared with the previous studies.

Some reinforcement attributes have been added to the traditional FMEA attributes in order to improve the results. Also, the problems of identical weights for attributes, inaccuracy in experts' opinions and the uncertainties in prioritizing the potential failures were improved. Furthermore, in addition to the need for less comparative data, the proposed approach is more accurate and comprehensive in its results.

Discusses the need for reliable research‐based evidence detailing the costs and benefits provided by different operational and strategic structures of renal replacement therapy. Suggests that in choosing the most appropriate form of dialysis the treatment options may be limited for clinical, practical or financial reasons. Proposes that the renal services must support patients in empowering them to make informed choices concerning the dialysis modality which offers them the highest quality of life. Brings into perspective the need for a balance between patients’ quality of life and the financial constraints on the NHS.