Missed Treatments

Everything you need to complete this module is right here! Click on the links below to access the necessary tools and resources available for completion of this module.

Objective:

To decrease the number of missed treatments due to non-adherence. Non-adherence is a situation in which the patient had a choice to attend or not attend. Situations such as hospitalization or vacationing at another unit would not penalize the patient.

Activities Required for Diamond Status/Measures:

100% of staff complete an in-service training module (PowerPoint Presentation) on missed treatments/patient non-compliance.
Track individual patient missed days by reason treatment was missed.
Provide feedback reports to patients indicating the number of days missed by reason and percent of actual treatments received vs. prescribed.
Educate patients about the difference between normal kidney function (168 hours/week), dialysis (approx. 12 hours/week), and their actual treatment received.
Decrease the total number of missed treatments due to non-adherence by >10%.
Sustain the improvement (decrease by >10%) for at least three months.

Optional Activities:

Create a game where patients can compete for recognition, nominal prizes/awards, or privileges by not missing treatment.
Develop an activity that addresses shortened treatments.
Educate staff about barriers to adherence and how to communicate more effectively with patients to encourage change.

Tools/Resources:

In-Service Training Module: Taking Time Out: Working with Non-Compliant Patients (with Speaker Notes)
Missed Treatment log for tracking monthly missed treatments
SURVIVOR Game Instructions
Sample Formal Letter
Sample Reinforcement Fliers 1, 2, 3
Patient Resources:
     - Are You Getting Enough Dialysis? brochure
     - Hemodialysis Dose and Adequacy brochure
     - Are You Shortening Your Dialysis Time? Fact Sheet
     - Partnering in Dialysis Care: Compliance and Self Management
     - Self Regulation
Staff Resource Articles:
     - Adherence in Patients on Dialysis: Strategies for Success (CNE Opportunity)
     - How Do I Protect Myself from a Non-Compliant Patient?
     - Wellness Programming: Nephrology Social Work Expands Its Role in Renal Disease Management

     - Using Motivational Interviewing to Promote Patient Behavior Change and Enhance Health
     - Dealing with the Non-Compliant Dialysis Patient: 10 Steps to Achieving Compliance
     - Techniques to Improve Compliance in Hemo- and Peritoneal Dialysis Patients

Printer friendly version of the Module Requirements List.

After you have completed the Missed Treatments module, and have documented the required measures, please complete and submit to your Network office:

Completed Project Reporting Form
In-service attendance log
Total number of Missed Treatments before in-service training
Total number of Missed Treatments for each month post- in-service training (for at least three months - see above measures)

If you have any questions or need assistance, please contact your specific Network.

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