Haemofiltration Education in a nurseled service'

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Haemofiltration Education in a nurse-led
service.

• D.Colvin, L.Heggan, C.Corbet.

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• 11-bedded Paediatric Intensive Care Unit.
• Approximately 1200 patients admitted and treated
  per year.
• 30-40 patients require haemofiltration every
  year.

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Background.

• Continuous veno-venous haemoflitration has been
  an established therapy at Great Ormond Street
  Hospital since 1994.
• The service was set up by a Consultant
  Intensivist and a team of senior nurses.
• Education, training management of the service
  is nurse-led with prescription from Consultant
  Intensivists.

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Patient Groups
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Haemofiltration Course

• This is a two-day course.
• It is aimed at nurses with a prerequisite of two
  years intensive care experience and an
  intensive-care qualification.
• They should also have an interest in advancing
  nursing practice and the responsibilities
  encapsulated within this.

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Course Programme

• Day One
• Indications for CVVH.
• The principles of CVVH.
• Clotting ACT measurement.
• Fluid electrolyte management.

• Day Two
• Nursing care of a child requiring CVVH.
• Fluid calculations scenarios.
• Lining priming the circuit.
• Complications troubleshooting.

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Post Course

• Post-course nurses are classified as trainees,
  working only with experienced haemofiltration
  nurses.

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Clinical Governance

• A system through which NHS organizations are
  accountable for continuously improving the
  quality of the services they provide. This also
  ensures the safeguarding of high standards of
  care, by creating an environment in which
  clinical excellence will flourish.

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Competency Books

• These are based on Benners theories models of
  nursing (1982).
• Trainees will develop from advanced beginner to
  expert practitioner.
• The time frame will be dependent on each
  individual and their exposure to CVVH.

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Competency Books

• Trainees must show evidence of, and demonstrate,
  a level of competency in the following areas
• Priming the circuit.
• Commencing CVVH.
• Fluid electrolyte management.
• Anticoagulation therapy
• Troubleshooting
• Discontinuing CVVH

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Conclusion

• In order for a our haemofiltration service to be
  successful, co-operation between the
  multi-professional team is essential.
• Dedication, enthusiasm and commitment are
  required from all involved.