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 would be those situations 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:	Complete an in-service training module (PowerPoint Presentation) on missed treatments/patient non-compliance. Track individual patient missed days. Provide feedback reports to patients indicating the number of days missed 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.
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 Excel spreadsheet for tracking and charting 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"   ~ "How Do I Protect Myself from a Noncompliant 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 Noncompliant Dialysis Patient: 10 Steps to Achieving Compliance" ~ "Techniques to Improve Compliance in Hemo-and Peritoneal Dialysis Patients"
MEASURE(S):	100% of staff in-serviced on missed treatments. Decrease the total number of missed treatments by > 10%. Sustain the improvement of decreased total number of missed treatments by > 10% for at least 3 months.

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After you have completed the Missed Treatments module, and have documented the required measures, please complete the Project Reporting Form and submit it to Heather Cecil at hcecil@nw5.esrd.net or by fax at 804.794.3793.

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