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Korean J Med > Volume 87(4); 2014 > Article
The Korean Journal of Medicine 2014;87(4): 439-448.
혈액투석의 질 관리에 영향을 미치는 요인
김경숙1, 이선희2, 류동열3
1서영대학교 간호학과
2이화여자대학교 의과대학 예방의학교실
3이대목동병원 신장내과
Factors Associated with Quality Control of Hemodialysis Treatment
Kyung Sook Kim1, Sun Hee Lee2, Dong Ryeol Ryu3
1Seoyeong University School of Nursing, Gwangju, Korea
2Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
3Division of Nephrology, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
Corresponding Author: Sun Hee Lee ,Tel: +82-2-2650-5754, Fax: +82-2-2645-1086, Email: lsh0270@ewha.ac.kr
Received: December 23, 2013;   Revised: February 20, 2014;   Accepted: May 3, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background/Aims:
The number of patients with end-stage renal disease in Korea is increasing annually with 63,341 patients in 2011 with 42,596 of these patients undergoing hemodialysis. The purpose of this study was to present a quality control plan for hemodialysis treatment.
Methods:
We analyzed 616 hemodialysis units in 2010. The difference between hospitals was analyzed by one-way analysis of variance and the Kruskal-Wallis H test. The factors related to outcome indicators were subjected to multiple regression analysis.
Results:
The average proportion of physicians with a specialty in hemodialysis was 71.3% and the proportion of nurses with > 2 years experience in hemodialysis units was 76.3%. The average number of hemodialysis sessions performed per day by a physician was 23 and that of a nurse was 4.5. The rate of specialist physicians was significantly related to adequate diastolic blood pressure, integrated outcome indicator, and Hb levels (p < 0.05). Hemodialysis sessions performed by a nurse were significantly related to Hb levels of patients and integrated outcome indicator (p < 0.05). The integrated outcome indicator was significantly related to specialist physicians, the number of hemodialysis sessions performed by a nurse, and compliance with a hemodialysis adequacy and water test cycles (p < 0.05).
Conclusions:
The appropriate rate of specialist physicians and nurses is important for quality control of hemodialysis treatment. Proper facilities and equipment, as well as regular monitoring of the patient’s condition, are also critical. This will require improved indicators and assessment reliability.
Keywords: Kidney failure, Chronic; Renal dialysis; Health facilities; Quality control; Medical staff
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