Quality statement 1: Education programmes

Quality statement

Adults preparing for or receiving renal replacement therapy, and their family members or carers, undertake individualised education programmes at specialist renal centres.

Rationale

Renal education programmes can improve patients' (and their family members' or carers') knowledge and understanding of the condition, and can help people to choose the treatment options that are most suitable for them. The benefits of pre‑dialysis education include improved wellbeing and physical functioning, as well as positively contributing to better planning and successfully starting dialysis, improved vascular access, delaying the need for starting dialysis and an increased likelihood of patients choosing self‑care.

Evidence also suggests that education is important to ensure that these benefits are maintained and that the person's involvement (including full participation of families and/or carers) in their care and treatment choices is optimised. This includes adults who start dialysis in an unplanned way.

Quality measures

Structure

Evidence that adults preparing for or receiving renal replacement therapy, and their family members or carers, undertake individualised education programmes at specialist renal centres.

Data source: Local data collection.

Process

a) Proportion of adults preparing for renal replacement therapy who undertake individualised education programmes at specialist renal centres.

Numerator – the number in the denominator who undertake individualised education programmes at specialist renal centres.

Denominator – the number of adults preparing for renal replacement therapy.

Data source: Local data collection.

b) Proportion of adults receiving renal replacement therapy who undertake individualised education programmes at specialist renal centres.

Numerator – the number in the denominator who undertake individualised education programmes at specialist renal centres.

Denominator – the number of adults receiving renal replacement therapy.

Data source: Local data collection.

c) Proportion of family members or carers of adults preparing for renal replacement therapy who undertake individualised education programmes at specialist renal centres.

Numerator – the number in the denominator who undertake individualised education programmes at specialist renal centres.

Denominator – the number of family members or carers of adults preparing for renal replacement therapy.

Data source: Local data collection.

d) Proportion of family members or carers of adults receiving renal replacement therapy who undertake individualised education programmes at specialist renal centres.

Numerator – the number in the denominator who undertake individualised education programmes at specialist renal centres.

Denominator – the number of family members or carers of adults receiving renal replacement therapy.

Data source: Local data collection.

Outcome

Patient satisfaction feedback from adults preparing for or receiving renal replacement therapy (and their family members and carers) about their individualised education programmes on renal replacement therapy at specialist renal centres.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (specialist renal centres) ensure that they provide individualised education programmes for adults who are preparing for or receiving renal replacement therapy, and their family members or carers.

Healthcare professionals ensure that they offer individualised education programmes to adults who are preparing for or receiving renal replacement therapy, and their family members or carers.

Commissioners (NHS England area teams) ensure that individualised education programmes are in place with clear referral pathways for adults preparing for or receiving renal replacement therapy, and their family members or carers.

What the quality statement means for patients, service users and carers

Adults who are preparing for or receiving renal replacement therapy (including those who start dialysis in an unplanned way), and their family members or carers, are offered an education course to improve their knowledge and understanding of the condition, and to help them choose the most appropriate options for treatment. The course will be adapted to the person's situation and preferences for learning, and will continue after treatment has started.

Source guidance

Definitions of terms used in this quality statement

Education programmes

Education programmes are aimed at improving patient and (if appropriate) family or carer knowledge, understanding of the condition and helping to choose from among the treatment options. The education programme should be tailored to the needs of the individual and be designed to support patient choice.

A range of teaching methods can be used within 1 session to allow learning to take place irrespective of the learning style. The information should be specifically designed to support decision‑making regarding treatment options. This should be relevant to the person, their disease stage and treatment options available to them, with the method, scale, pace and scope of the delivery being suited to the individual's learning style, capacity and preferences.

A variety of approaches should be available. These include:

  • individual conversations

  • group work

  • written materials

  • DVD/CDs and Internet resources

  • decision‑making aids

  • access to expert patients with appropriate training.

The education programme should be offered to adults who are preparing for renal replacement therapy (adults with severe chronic kidney disease [stage 5 and progressive stage 4]), and to adults who present late and start dialysis in an unplanned way, and to their families or carers, if appropriate.

The programme should also provide continuing education for adults receiving dialysis, and their family members or carers (if appropriate), with the aims of reviewing the original choice made by the patient, optimising patient involvement in their own care, improving treatment adherence, and fostering good communication and collaborative relationships with caregivers.

[Adapted from The Renal Association's clinical practice guideline on planning, initiating and withdrawal of renal replacement therapy, recommendations 4.1, 4.2 and 4.3 including rationale]

Equality and diversity considerations

Information should be provided in an accessible format (particularly for people with physical, sensory or learning disabilities and those who do not speak or read English) and educational materials should be translated where appropriate.