Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care
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 (N...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024923016285 |
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| author | Sami Alasfar Hani Alashavi Khaled Hajj Nasan Abd Aljabbar Haj Mousa Camila Polinori Valerie Luyckx Mohamed Sekkarie Saleh Kaysi Lina Murad Gilbert M. Burnham |
| author_facet | Sami Alasfar Hani Alashavi Khaled Hajj Nasan Abd Aljabbar Haj Mousa Camila Polinori Valerie Luyckx Mohamed Sekkarie Saleh Kaysi Lina Murad Gilbert M. Burnham |
| author_sort | Sami Alasfar |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-6b7c0920249144c5a5d42f0fc0f30996 |
| institution | DOAJ |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-6b7c0920249144c5a5d42f0fc0f309962025-08-20T03:20:30ZengElsevierKidney International Reports2468-02492024-03-019358058810.1016/j.ekir.2023.12.006Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective CareSami Alasfar0Hani Alashavi1Khaled Hajj Nasan2Abd Aljabbar Haj Mousa3Camila Polinori4Valerie Luyckx5Mohamed Sekkarie6Saleh Kaysi7Lina Murad8Gilbert M. Burnham9Department of Medicine, Division of Nephrology, Mayo Clinic Arizona, Phoenix, Arizona, USA; Correspondence: Sami Alasfar, Department of Medicine, Division of Nephrology, Mayo Clinic Arizona, 5779 E Mayo Blvd, Phoenix, Arizona 85054, USA.The World Health Organization office in Gaziantep, Gaziantep, TürkiyeDepartment of Medicine, Dr. Muhammad Waseem Maaz Hospital, Azaz, Northwest Syria, SyriaIndependent ResearcherDepartment of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USARenal 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, SwitzerlandNephrology and Hypertension Associates, Bluefield, West Virginia, USADepartment of Medicine, Division of Nephrology, Brugmann University Hospital, Brussels, BelgiumSyrian National Kidney Foundation, Washington, District of Columbia, USA; Metropolitan Access Center, Colmar Manor, Maryland, USADepartment of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland, USAIntroduction: 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.http://www.sciencedirect.com/science/article/pii/S2468024923016285conflicthemodialysiskidney failurewars |
| spellingShingle | Sami Alasfar Hani Alashavi Khaled Hajj Nasan Abd Aljabbar Haj Mousa Camila Polinori Valerie Luyckx Mohamed Sekkarie Saleh Kaysi Lina Murad Gilbert M. Burnham Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care Kidney International Reports conflict hemodialysis kidney failure wars |
| title | Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care |
| title_full | Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care |
| title_fullStr | Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care |
| title_full_unstemmed | Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care |
| title_short | Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care |
| title_sort | providing hemodialysis in unstable areas an assessment and framework for effective care |
| topic | conflict hemodialysis kidney failure wars |
| url | http://www.sciencedirect.com/science/article/pii/S2468024923016285 |
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