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4.5 Patient/Carer Experience 4.5.3 Admission to Hospital While the number of days RRT patients spend in hospital every year are relatively few (European average 11.3 days) (ref.81) the individual patient experience is extremely varied. While it is not uncommon for fit patients to go several years between hospitalisations, some of the more dependent patients need repeated admissions. At any time, approximately 50% of inpatient nephrology beds will be occupied by RRT patients with intercurrent problems. The juxtaposition of patients newly diagnosed with ESRF and RRT patients, some of whom will have serious medical problems, or may be in the terminal phases of their illness demands the highest levels of nursing skill and an environment suitable for the care of patients with the whole range of renal diseases. RRT patients admitted to hospital should expect to be admitted to a purpose designed nephrology ward staffed by renal trained nurses, some ideally with experience in intensive care and others who are competent in haemodialysis. Patients with acute renal failure often receive dialysis on the nephrology ward as do patients admitted from outlying satellite haemodialysis units. The number of nephrology beds required should keep pace with the numbers supported on dialysis (see Section 5.8). If facilities are inadequate, RRT patients have to be admitted to 'outlying' wards where they will be looked after by nurses who are not renal trained. This should be the exception. Patients should also expect single sex areas on the nephrology ward with appropriate shower, bathing and toilet areas. Quiet areas for interviewing patients and families should be part of the fabric of the nephrology ward.  |