Background
Aboriginal people are four times more likely to die from renal disease than non-Aboriginal people. Individuals living in remote areas face an accelerated development of Chronic Kidney Disease (CKD), which is compounded by health service access inequities, socioeconomic disadvantage, lower educational attainment, and lower incomes. In response, the WA Country Health Service Pilbara Renal Service (WPRS) is pivoting its focus toward prevention, early identification, and slowing disease progression. Preventative actions are less expensive and yield a greater impact on health outcomes; they can avoid the onset of kidney disease altogether and reduce overall disease severity. As part of its primary prevention strategy, WPRS offers innovative service delivery by operating nursing clinics directly in patients' homes and providing education on how environmental health can prevent kidney disease.
Aim
The purpose of this research is to observe how home visits and environmental health education can delay renal disease progression in the Pilbara region, while simultaneously addressing nonattendance at hospital-based renal nursing clinics.
Methods
This one-year observational research project followed the renal care journeys of three patients selected via purposive sampling. Due to a history of frequent nonattendance at hospital-based clinics, these patients received regular home visits from nurses who conducted clinical nursing assessments and provided educational services.
Results
Home visits are effective in delaying renal disease progression and improving patient readiness for dialysis. This model successfully addresses the issue of nonattendance at hospital-based clinics. Furthermore, the higher patient engagement provided by home visits improves overall health outcomes and allows for a seamless transition from CKD management to end-stage renal replacement therapy. Additionally, home-based care strengthens dialysis compliance during the end stage of the disease.
An unexpected, positive outcome of these home visits was the opportunity for nurses to include relatives living with the patients in the educational sessions. This collective approach expanded the reach of kidney disease prevention education and highlighted how the home environment significantly impacts health outcomes.