A team-focused approach that involves nurses and patient care technicians is effective in improving serum phosphorus levels in hemodialysis (HD) patients, researchers reported at the National Kidney Foundation’s 2014 Spring Clinical Meeting in Las Vegas.

In a 3-month intervention-based study, Jacquelyn Martinez, RD, and colleagues at Satellite Healthcare in Gilroy, Calif., examined the effects of monthly educational demonstrations on in-center HD. They divided patients into 3 teams and measured the percentage of patients who achieved serum phosphorus levels of 5.5 mg/dL or less every month.

Patients were instructed by nurses and patient care technicians. Educational topics and demonstrations were designed by renal dietitians. Teams were awarded small prizes for each month as well as a grand prize for the overall study.


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In the first month, patients were reminded to take phosphate binders. The second month emphasized appropriate timing of phosphate binder usage, and the third month involved a demonstration of how phosphate binders absorb phosphorus in food within the stomach.

By the end of the study, all teams showed improvement in achieving serum phosphorus levels 5.5 mg/dL or less.

In addition, the researchers found that frequent contact between nurses, technicians, and patients helped them to better understand strategies in phosphorus control as well as reinforce educational objectives in patients.