The Box Butte General Hospital (BBGH) Dialysis Unit has been holding a phosphorus target level drawing for cash the past three months to encourage their patients to improve their lab profiles in that area, along with educational projects, posters and games. The contest and combined efforts of both patients and staff have been a success.
The phosphorus target range for a dialysis patient is 3.5-5.5 mg/dL (milligrams per deciliter of blood - a deciliter being equal to one-tenth of a liter), as measured by monthly lab results. The past three months of games, education and contest drawings have resulted in the number of patients hitting that target increasing from 46 percent to 62 percent. "And we have some patients who had previously very high phosphorus levels closer to their target," said Dialysis Unit Manger Paulette Burkhardt, RN.
She said one of the indicators used to measure the performance of dialysis service units is the percent of patients that make a target range in a number of areas, including anemia, adequacy (how much toxin is removed during a given dialysis treatment), diet and bone health. "There are several others, but what concerned me earlier this year were the percentages of patients not meeting their phosphorus levels," Ms. Burkhardt said. "We have great patients, but it is hard to maintain the proper level of phosphorus for individuals on dialysis."
When a patient has high phosphorus blood levels, the body wants to balance with calcium. The calcium is usually pulled from bone, making a weak skeletal system. "Then the body senses too much calcium in the blood and starts to lay it down in soft tissue, like arteries, the heart or brain," she continued. "Obviously that leads to other severe complications. So I challenged the staff to move more of our patients into, or at least closer to, the target range for phosphorus. Their response and the response of our patients lead to much better percentages and lowered the levels of some patients with higher levels."
Publicity about the three month effort drew the attention of the Nebraska Kidney Foundation. "They heard about our project and sent over some travel mugs to be given to the winners," Ms. Burkhardt said. "I visited with one of their representatives and we may be mentioned in their newsletter. So this project has affected more than the Dialysis Unit at BBGH."
The winner of the July drawing was Therese Weber, shown here receiving her certificate and $20 cash reward from Dialysis Unit Manager Paulette Burkhardt, RN.