The next stage for NxStage

In late 2014, the BC Renal Agency completed a pilot project evaluating the potential benefits of NxStage™, a hemodialysis system that is relatively new to the Canadian market and was designed specifically for use in the home.

Results of the pilot project demonstrated that NxStage could offer an alternative to the Baxter/Gambro home hemodialysis machine currently in use across the province. This is especially the case for kidney patients who haven’t been able to participate in home hemodialysis before due to various limitations (e.g. renal requirements, difficulties with water supply, etc.) and others who could benefit from the simplicity of the NxStage system. 

PROMIS Update

A number of simple changes will be introduced to the way patient data is entered into PROMIS this summer. The changes have been requested by the Canadian Organ Replacement Register(CORR) and are designed to improve the electronic transfer of BC patient data to the CORR database. 

Book Review

I, Kidney gives renal nurse a new perspective 

In March, we offered a free copy of I, Kidney, by New York–based author Chris Six, to any Renal News reader willing to write a review of the book. Fraser Health nurse Sarah Bonikowsky responded to our request and has prepared the following review. 

Nocturnal HD toolkit

The BC Renal Agency’s HD committee has created a “toolkit” for renal programs interested in developing a successful nocturnal HD program. The toolkit is currently undergoing a final review by the committee prior to being posted to the BC Renal Agency website. It is expected the toolkit will be available this summer. 

HD patient welcome package

A provincial hemodialysis “welcome package" is being developed for patients preparing for the transition to HD. The effort is directed by a working group of the BC Renal Agency’s HD committee, with input from patient advisors identified by members of the working group.  A draft welcome package has been prepared and is currently circulating amongst the HD community for review and feedback. After final approval by the HD committee, the welcome package will be posted on the BCPRA website in the fall.

New guideline for visiting HD patients

The BC Renal Agency’s HD committee has developed a provincial guideline to standardize the processes and forms used for dialysis patients visiting HD clinics other than their normal clinic. This applies to both BC patients away from their “home” clinic and to patients from other provinces or countries receiving HD treatment in BC. The guideline and forms are currently being tested in selected HD units and will be revised based on feedback from the participating units. It is expected the new guideline and forms will be rolled out province-wide this fall. 

Vascular access report

The latest vascular access (VA) indicator report shows some positive results. For the six months between October 2014 and March 2015 the incidence rate for fistulas and grafts remained steady at 33%. This means that 33% of patients who started hemodialysis (HD) during the period started with a fistula or graft. 

Kidney Care Committee priorities for 2015

The BC Renal Agency Kidney Care Committee (KCC) has identified three priorities for the coming year. 

1. Following development of its anxiety and depression guideline, the KCC will pursue opportunities to build awareness and use of the guideline by KCC staff and physicians. 
2. Symptom assessment and management for all KCC patients with failing kidneys (eGFR<15) is a second priority. This involves using the modified ESAS (Edmonton Symptom Assessment System) tool to identifying patients with symptoms such as pruritus, insomnia and pain, helping patients manage their symptoms and tracking the results of those efforts.
3. The third priority is to implement the algorithm developed by the KCC last year as part of its best practices guideline in support of patients choosing conservative care. The algorithm identifies processes related to advance care planning (ACP) and best practices in providing conservative care. Implementing the algorithm will require training for KCC staff, physicians and renal managers about the algorithm and the role of conservative care in patients with advanced kidney disease. 

Kidney Care Report Results

The results from the latest provincial Kidney Care Committee (KCC) key indicator report show improvements in some areas and declines in others. 

On the positive side, the report shows for the six-month period ending in March 2015, 63% of patients with failing kidneys (eGFR<15) had specified hemodialysis (HD) as their chosen modality and had a pre-emptive fistula or graft in place. This was a 12% increase from the results obtained for the same period ending March 2012.  

Leadership Changes at BC Transplant

BC Transplant is undergoing a process of leadership change. In the past month BCT’s provincial operations director, Amber Appleby, left the organization to take a position with Canadian Blood Services. BCT’s provincial executive director, Dr. Greg Grant has also left to return full time to his critical care practice.

Kidney Summit on Organ Donation

Submitted by the Kidney Foundation of Canada, BC and Yukon Branch
More than 400 kidney patients, health care professionals, policy makers and others from the kidney community attended BC’s first-ever Kidney Transplant Summit. 

Held in May and sponsored by the BC branch of the Kidney Foundation of Canada, the summit was focused on the need for increasing organ donor registration and kidney transplants.

Kidney Health Month 2015

This past March, the BC Renal Agency promoted its annual World Kidney Day and Kidney Smart initiatives across BC. These efforts are aimed at informing the public and high-risk groups about the importance of detecting kidney disease early and about healthy lifestyle choices for maintaining kidney health. 

Renal initiative wins BC Quality Award

A BC Renal Agency team was honoured with the 2015 BC Quality Award in the “Getting Better” category.

Renal presentations at BC Quality Forum

The BC Quality Forum is an annual event featuring health care professionals from across the province coming together to share what they have done to improve health care quality in their area. The best of these initiatives are recognized with a BC Quality Award, sponsored by the BC Patient Safety and Quality Council.
 

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