An audit of anaemia in haemodialysis patients.

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The following is an example of how this writer (as a nurse) would develop, implement, and evaluate an audit of anaemia in haemodialysis patients. The measures put forth here are consistent with contemporary health policy and the evolving role of the specialist nurse.

Introduction

According to the NICE guidelines, published by the Royal College of Physicians, "Conventionally anaemia is defined as a haemoglobin concentration lower than[normal as defined by WHO]. This cut-off figure ranges from 11 grams per decilitre (g/dl) for pregnant women and for children between 6 months and 5 years of age, to 12 g/dl for non-pregnant women, and to 13 g/dl for men."1
"In 2002, Hsu et. al. analyzed data from the Third National Health and Nutritional Examination Survey (NHANES III) (n=15,837) and found low iron indices to be frequently present at all levels of reduced creatinine clearance (CrCl)."2 Additionally, "[m]ore than 50% of CKD patients with an[a]emia were iron deficient, as indicated by serum ferritin <100 ng/mL or TSAT <20%."3
For CKD (Chronic Kidney Disease) patients, the ideal format of developing an audit for haemoglobin patients include three main factors. These factors are: things the clinician should do; what are best practices regarding treatment; and finally any pharmacological considerations that should be taken into account when considering the audit of anaemia in haemoglobin patients.
First of all, one of the most important issues that may come up with regard to what the clinician should do is that he or she, as a nurse, must consider all the possible contraindications that could come up in the course of the patient's treatment.
This is because, if a patient is, for example, allergic to ...
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