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How Onsite Dialysis Facilitated Care During Hurricane Ian

04/22/2023 | Gilda Jones, RN, CNN, Vice President of Clinical Services

There are many moving parts to consider when providing healthcare services during a natural disaster. Hospitals, nursing homes, and other providers must develop and implement emergency plans for these contingencies. In the case of dialysis, there are several important considerations: availability of dialysis equipment, filtration systems for the water used in dialysis, and the sanitation level of the water itself.

The use of in-home dialysis equipment combined with the more frequent dialysis (MFD) model for providing treatment, lends itself naturally to an adaptable approach to managing dialysis care in disaster situations. 

Dialyze Direct utilizes the NxStage system, a highly portable dialysis machine that uses far less water than conventional dialysis. Recently, during Hurricane Ian, we saw how this treatment modality, in combination with world-class staff, resulted in a tremendously positive outcome for onsite skilled nursing facility (SNF) patients enrolled in our care.

The NxStage dialysis system 

Conventional dialysis machines are bulky and require a large filtration system. They cannot be easily moved ahead of a natural disaster or easily relocated in the aftermath of one. Especially notable is the fact that they require large amounts of treated water- something that was not readily available after Hurricane Ian’s landfall.

To successfully dialyze patients with conventional dialysis during a natural disaster like Hurricane Ian, massive tanker trucks of water would be needed. With the NxStage machines, approximately 4-6 bags of pre-mixed dialysate weighing around 25 pounds are required for each treatment. During Hurricane Ian, with an appropriate emergency stock of dialysate bags, it was easy to provide safe water in quantities needed to provide treatment. This was despite boil orders in place after flooding occurred.

In addition, because the NxStage system is only 122 pounds and can be taken apart into two separate components and carried, these machines were portable enough to move to sister dialysis sites away from the storm’s direct path. In fact, in an emergency situation like a hurricane, it is possible to only move the top portion of the machine– weighing in at around 55 pounds– and the dialysate bags. In contrast, the entire filtration system and machine would be necessary with a conventional dialysis machine and weighs substantially more- as much as 300 pounds.

The onsite dialysis model

Dialyze Direct offers onsite dialysis in treatment “dens” at partner SNFs. These treatments take place five days per week (pursuant to a physician’s order), for a duration of under three hours. Because of this modality, the potential existed ahead of the hurricane to offer treatments earlier in the day than normally scheduled, in order to accommodate time for transportation to facilities away from the storm’s path. 

Additionally, in cases where patients were moved to sister facilities and scheduling had to accommodate more patients, these shorter treatment times meant that it was easier to coordinate scheduling dialysis for an increased patient census.

The benefit of a network of facilities

During Hurricane Ian, Dialyze Direct’s patients saw the immediate benefit of having access to multiple onsite options. Because the SNFs they resided in had sister facilities that also partnered with Dialyze Direct, these residents were able to be relocated, along with the NxStage equipment, to alternative SNFs for treatment. 

This process of continuing treatments was seamless, with electronic medical records transferring easily, and staff willingly relocating temporarily to assist patients with their care needs. Where other SNFs may have been forced to relocate some patients to local hospitals for care, further burdening the healthcare system and occupying beds needed for medical emergencies, Dialyze Direct patients were able to avoid hospitalizations, both during and after the disaster.

The quality of Dialyze Direct care delivery

To deliver dialysis care with the NxStage system and MFD, Dialyze Direct’s nurses and team members are specially trained. During Hurricane Ian, their unique and patient-centered care was especially highlighted, as caregivers mobilized to work both earlier and later than their usual shifts to ensure all patients received their prescribed treatments. Staff were also willing to leave their homes for extended periods to stay with patients at non-local SNFs to offer dialysis until they could be safely transferred back to their original SNFs. 

It is this dedication and innovation that is at the heart of what Dialyze Direct does. Our dialysis patients in partner SNFs can expect better recovery times and better quality of life, and as this natural disaster illustrated, continuity of care even in challenging times.

For more information on how to join more than 200 locations in 14 states in bringing the Dialyze Difference to patients, contact David Schneck, Director of Managed Care, at (718) 506-1739, or via email at dschneck@dialyzedirect.com.

About The Author

Gilda Jones, RN, CNN is a seasoned nephrology nurse who has experience spanning nearly 4 decades, from clinical care to roles as director of nursing. As  Vice President of Clinical Services for Dialyze Direct, she provides education to staff and patients, oversees patient outcomes and manages all aspects of the dialysis units for which she is responsible. She enjoys mentoring nursing staff and providing CEU programs to help nephrology nurses excel at dialysis care.