QUALITY ASSESSMENT OF HEMODIALYSIS SERVICES: A STUDY OF TWO CENTERS FROM IRAQ

Introduction:

Measuring the quality of healthcare services in hemodialysis is invaluable for improving the care delivered. Quality assessment tools include, but are not limited to, patient satisfaction and other objective performance measures. This study assesses patient satisfaction and specific performance indicators in two Iraqi hemodialysis centers. 

Methods:

A cross-sectional study with analytical elements was conducted in two governmental centers in Baghdad from March 1 to July 1, 2023. Two hundred Iraqi prevalent hemodialysis patients were recruited. Patient satisfaction was assessed through a validated questionnaire that assesses satisfaction with medical staff interactions and care before, during, and after dialysis. There were 14 items to which patients were answered as dissatisfied, neutral, satisfied, or very satisfied (Likert 4-point scale). The objective performance indicators were vascular access, dialysis time and frequency, hemoglobin level, serum albumin, phosphate, and PTH levels. 

Results:

The mean age of the study group is 49.7 + 15.1 years, with 112 (56%) males. The average hemodialysis session time is 180 – 200 minutes; only 5% of the participants have 4 HD sessions weekly. The study group was generally satisfied with nursing care and dialysis session delivery. The lowest satisfaction score was post-dialysis follow-up and communication between dialysis sessions. The mean hemoglobin level is 9.5 + 1.5 g/dl, and the mean serum albumin is 3.8 + 0.4 g/dl. The mean serum phosphate is 6.4 + 1.3 mg/dl, and 122 patients (61%) have > 5 mg/dl serum phosphate. The mean serum PTH is 476.5 + 36.9 Pg/ml. 

Conclusions:

The study cohort was satisfied with the nursing and delivery of the hemodialysis procedure. Unfortunately, such a subjective tool hasn’t matched objective performance indicators in the two hemodialysis units. This emphasizes the importance of quality assessment and improvement education for dialysis professionals and patients to improve services. A nationwide study to assess hemodialysis quality is mandatory.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.