혈액투석의 질 관리에 영향을 미치는 요인
Factors Associated with Quality Control of Hemodialysis Treatment
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Background/Aims: The number of patients with end-stage renal disease in Korea is increasing annually with 63,341 patients in2011 with 42,596 of these patients undergoing hemodialysis. The purpose of this study was to present a quality control plan forhemodialysis treatment. Methods: We analyzed 616 hemodialysis units in 2010. The difference between hospitals was analyzed by one-way analysis ofvariance and the Kruskal-Wallis H test. The factors related to outcome indicators were subjected to multiple regression analysis. Results: The average proportion of physicians with a specialty in hemodialysis was 71.3% and the proportion of nurses with > 2years experience in hemodialysis units was 76.3%. The average number of hemodialysis sessions performed per day by a physicianwas 23 and that of a nurse was 4.5. The rate of specialist physicians was significantly related to adequate diastolic blood pressure,integrated outcome indicator, and Hb levels (p < 0.05). Hemodialysis sessions performed by a nurse were significantly related to Hblevels of patients and integrated outcome indicator (p < 0.05). The integrated outcome indicator was significantly related tospecialist physicians, the number of hemodialysis sessions performed by a nurse, and compliance with a hemodialysis adequacy andwater test cycles (p < 0.05). Conclusions: The appropriate rate of specialist physicians and nurses is important for quality control of hemodialysis treatment. Proper facilities and equipment, as well as regular monitoring of the patient’s condition, are also critical. This will require improvedindicators and assessment reliability.
Abstract
Background/Aims: The number of patients with end-stage renal disease in Korea is increasing annually with 63,341 patients in2011 with 42,596 of these patients undergoing hemodialysis. The purpose of this study was to present a quality control plan forhemodialysis treatment. Methods: We analyzed 616 hemodialysis units in 2010. The difference between hospitals was analyzed by one-way analysis ofvariance and the Kruskal-Wallis H test. The factors related to outcome indicators were subjected to multiple regression analysis. Results: The average proportion of physicians with a specialty in hemodialysis was 71.3% and the proportion of nurses with > 2years experience in hemodialysis units was 76.3%. The average number of hemodialysis sessions performed per day by a physicianwas 23 and that of a nurse was 4.5. The rate of specialist physicians was significantly related to adequate diastolic blood pressure,integrated outcome indicator, and Hb levels (p < 0.05). Hemodialysis sessions performed by a nurse were significantly related to Hblevels of patients and integrated outcome indicator (p < 0.05). The integrated outcome indicator was significantly related tospecialist physicians, the number of hemodialysis sessions performed by a nurse, and compliance with a hemodialysis adequacy andwater test cycles (p < 0.05). Conclusions: The appropriate rate of specialist physicians and nurses is important for quality control of hemodialysis treatment. Proper facilities and equipment, as well as regular monitoring of the patient’s condition, are also critical. This will require improvedindicators and assessment reliability.
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