Blood pressure control in haemodialysis patients: an audit.
OBJECTIVE
This audit was conducted to study the level of achievement of some criteria relevant to blood pressure control in haemodialysis patients and to evaluate if auditing process improves the quality of medical care given to these patients.


METHODS
The records of all 105 patients on maintenance haemodialysis were included in the study. Five criteria relevant to blood pressure control were selected for auditing. The criteria were: predialysis blood pressure control <140/80, dry weight, dialysis adequacy, salt and water intake restriction, and patient education. The auditing process was conducted at two different times 6 months apart.


RESULTS
The first data collected in the auditing process showed that there were only 40 patients (38%) with controlled predialysis blood pressure. In the second data collection the number of patients with controlled predialysis blood pressure had risen significantly to 78 (74.3%), P < 0.0001. The same improvement was achieved for dry weight 39 (37%) to 73 (69.5%) P < 0.0001, dialysis adequacy 38 (36.2%) to 75 (71.4%) P = 0.043, salt and water intake restriction 39 (37%) to 71 (67.6%) P = 0.045, and patient education 30 (28.6%) to 55 (52.4%) P < 0.0001.


CONCLUSIONS
Setting up audit cycles to evaluate achievement of required standard in relevant criteria contribute to better blood pressure control and leads to improvement in the care of patients on dialysis. Auditing can be an essential tool in identification of poorly controlled blood pressure, its cause and is useful in control of hypertension in the haemodialysis population.
Al-Hilali
Nabieh
N
Department of Medicine, Mubarak AI-Kabeer Hospital, Kuwait. dralhilali@yahoo.com
Al-Humoud
Hani
H
Ninan
Vadakethu T
VT
Nampoory
Mangalathillam Rn
MR
Johny
Kaivilayil V
KV