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Renal Process Mapping from Renal Stakeholder Event

PATIENT ENTRY POINTS INTO ACUTE CARE. Renal Process Mapping from Renal Stakeholder Event. Outpatient Appointment. Nephrologist refers to. General Practitioner. Emergency. Vascular Access Co-ordinator appt booked at. Inpatient Ward. New Outpatient Appt. Secondary Referral.

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Renal Process Mapping from Renal Stakeholder Event

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  1. PATIENT ENTRY POINTS INTO ACUTE CARE Renal Process Mapping from Renal Stakeholder Event Outpatient Appointment Nephrologist refers to General Practitioner Emergency Vascular Access Co-ordinator appt booked at Inpatient Ward New Outpatient Appt Secondary Referral Tertiary Referral RAC Blood Screen Vascular Access Assessment Clinic Urinalysis/24hr save Results Downloaded to MARS Database & PICS (electronic prescribing System) First contact with Nephrologist Renal Biopsy Radiological intervention Ultrasound mapping of veins & surgical plan identified 24hr blood pressure monitoring Diagnostic tests ordered No further action required. Discharge to referrer. Ultrasound of kidneys Follow up Appt with Nephrologist & refer to Community Nursing Team Venogram Venoplasty Patient Prioritised & listed for surgery (Pt must be fit and ready) Angiogram of renal vasculature Results to referring Clinician Modality Choice Pre-clerking Clinic Appt SURGERY For access formation (Day case/ Elective) Dialysis location Dialysis work up TRANSPLANTATION CONSERVATIVE MANAGEMENT PERITONEAL DIALYSIS HAEMODIALYSIS Not desired by patient Hepatitis vaccination Dietetic Advice Anaemia Management Prognosis and information Physical support Psychological support Physical catheter placement Surgical catheter placement Desired by patient Access Maturation 6-8 weeks Consultant/ Self referral Dialysis Access Formation Living Donor Cadaveric Transplant Episode ends Not suitable CAPD training First and subsequent dialysis Transonic Monitoring (quarterly per protocol) Radiological intervention Bloods and TX Chat Transplant donor First stage Transplant Assessment Recipient Not suitable Reviewed by Physician/ Surgeon Suitable Episode ends Failed CAPD access Failed/ Blocked fistula access Dialysis via temporary Line Second stage assessment Psychological Community Nursing Team support/advise Suitable MRI Added to waiting list ECG/CXR Hospital Home Satellite Results sent to Echocardiogram/Angiogram Pre-clerking Modality Choice Blood Tests Refer back to Vascular Access Co-ordinator for review of access plan Transplant Survival Transplantation Transplant Failure Exercise tolerance test

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