The Implementation of a Modified Fluid Assessment Tool to Improve the Clinical Assessment, Detection, and Management of Blood Pressure Control and Fluid Alterations Among Hemodialysis Patients

Hussam Al Nusair,1 Wael Hamdan,1 Joy Garma,1 Ahmed Eid,1 Rafi Alnjadat,2 Nezam Al-Nsair,3 Mariezl Fonbuena,1 Christin Davao1 1Dialysis Department, Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates; 2Applied Health Sciences, Al-Balqa Applied University, Irbid, Jordan; 3College of Nursing, Xavier University, Cincinnati, OH, USACorrespondence: Rafi Alnjadat, Applied Health Sciences, Al-Balqa Applied University, Irbid, Jordan, Tel +962772496680, Email rafi.alnjadat@bau.edu.joBackground: Fluid overload is a common complication of the care of End-stage Renal Disease patients that may lead to prolonged hospitalization and mortality. This warrants an effective and systemic approach to early recognition and management to improve patient outcomes.Aim: This study aims to evaluate the effect of a modified fluid assessment tool to improve accurate clinical assessments, detection, and management of blood pressure control and fluid alteration among hemodialysis patients.Methods: In this retrospective study, data were collected from forty-three dialysis patients who were seen and followed up from a dialysis unit of an acute care hospital during 8 weeks of standard care. A modified assessment tool was used to systematically highlight the appropriateness of the patient set dry weight using intradialytic weight gain (IWDG) and patient blood pressure. Paired sample t-test and repeated measure ANOVA within-group analysis were applied to compare the mean difference score for IDWG and the mean arterial pressure within the study group, respectively.Result: A total of 43 patients were enrolled (mean age, 59.07) (ranges 27– 88 years) (SD – 14.30); 51.16% female; 79% Emirati Nationals, with Chronic Kidney Disease. A repeated measure ANOVA analysis showed a significant difference in the mean arterial pressure within the study group based on time, over six measurements (p = 0.001). However, the difference between the pre- and post-intra-dialytic weight gain mean scores yi