The Perfect Storm: Stakeholder Perspectives on Factors Contributing to Hospital Admissions for Patients Undergoing Maintenance Hemodialysis.

Patients living with end stage renal disease (ESRD) who are undergoing hemodialysis experience frequent hospitalizations associated with complications of care and exacerbations of illness. Efforts to reduce hospitalizations have had limited success. The purpose of this study was to explore why hospitalizations occur from the perspectives of patients undergoing hemodialysis treatment, their caregivers, and health care providers. Semi-structured interviews and focus groups were conducted with 21 patients living with ESRD, 10 caregivers, and three focus groups with health care professionals. Findings are discussed under four main themes: Graft site/Catheter/Access issues, "My resistance is low," "I could not breathe,"" and "The perfect storm." Results highlight the complexity of care and vulnerability of patients with ESRD. Further interprofessional research is needed to improve transitional care and care delivery for patient populations receiving hemodialysis.
Competing Interests: This study was supported through a pilot grant from the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. Maya Clark-Cutaia was supported in part by a NIH-NINR K23 Mentored Patient-Oriented Research Career Development Award Recipient (NR015058-01). Olga Jarrín was supported in part by an AHRQ/PCOR K99/R00 award (HS022406).
(Copyright© by the American Nephrology Nurses Association.)