Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care.

Autor:	Alasfar S; Department of Medicine, Division of Nephrology, Mayo Clinic Arizona, Phoenix, Arizona, USA., Alashavi H; The World Health Organization office in Gaziantep, Gaziantep, Türkiye., Nasan KH; Department of Medicine, Dr. Muhammad Waseem Maaz Hospital, Azaz, Northwest Syria, Syria., Haj Mousa AA; Independent Researcher., Polinori C; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA., Luyckx V; Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland., Sekkarie M; Nephrology and Hypertension Associates, Bluefield, West Virginia, USA., Kaysi S; Department of Medicine, Division of Nephrology, Brugmann University Hospital, Brussels, Belgium., Murad L; Syrian National Kidney Foundation, Washington, District of Columbia, USA.; Metropolitan Access Center, Colmar Manor, Maryland, USA., Burnham GM; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Kidney international reports [Kidney Int Rep] 2023 Dec 20; Vol. 9 (3), pp. 580-588. Date of Electronic Publication: 2023 Dec 20 (Print Publication: 2024).
DOI:	10.1016/j.ekir.2023.12.006
Abstrakt:	Introduction: Providing hemodialysis to patients with kidney failure (KF) in conflict-affected areas poses a significant challenge. Achieving and sustaining reasonable quality hemodialysis operations in such regions necessitates a comprehensive approach. Methods: In the conflict area of Northwest (NW) Syria, a 3-phase project was initiated to address the quality of hemodialysis operations. The assessment phase involved the examination of infection prevention and control (IPC) protocols, staff training, medical protocols, individualized hemodialysis prescriptions, and laboratory testing capabilities. The second phase involved activities toward capacity building and implementing an action plan based on feasibility and sustainability. Results: The assessment phase revealed that only 7 of 14 centers had IPC protocols, and 8 centers provided IPC training for their staff. Furthermore, only 7 centers had medical protocols, and 5 used individualized hemodialysis prescriptions. Difficulties in testing for potassium was reported in 7 centers and the inability to perform hepatitis B and C serologies was reported in 3 centers. Only 2 centers adhered to machine and water treatment system maintenance guidelines, and 4 conducted daily water quality checks. Recommendations were formulated, and an action plan was developed for implementation in the second phase. The plan encompassed enhancements in IPC practices, medical protocols, record-keeping, laboratory testing, and equipment maintenance. Conclusion: This project underscores that hemodialysis services in conflict-affected areas do not meet the standards for quality care. It emphasizes the necessity of implementing a comprehensive framework that engages relevant stakeholders in defining and upholding quality care, a model that should be extended to other protracted conflict-affected regions. (© 2024 Published by Elsevier, Inc.)
Databáze:	MEDLINE
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