S 08 Parallel Session

O 13
Implementation of Motivational Interviewing in practice
M. Berg¹, L. Rasmussen¹, B. Baek^1
1Nephrology, Odense University Hospital, Odense, Denmark

Background: In 2012, research of patients admitted to the Nephrology ward showed that patients did not experience acknowledgement on admission, although nurses are educated in 'Motivational Interviewing' (MI).  Two nurses saw an opportunity to make their colleagues competent in MI skills.
Objectives: To develop skills in MI, the nurse must identify the patient's resources and mutual expectations for admission.  To tackle the issues that feel relevant or are difficult for the patient.
Methods: Breakthrough series method and Plan Do Study Act circles.
Conduct a literature search.
Two Nurses advised, trained and facilitated their colleagues in the process.
Prepare the organization for the change by introducing role-play and feedback.
Four colleagues were selected to train intensively in MI.
Pre -focus group interviews, IN - exercise at the ward, AFTER - focus group interviews.
Competency Maps for documenting training and retaining MI.
Results:The four selected colleagues aroused curiosity and motivation and the two nurses gained great knowledge from their colleagues’ prerequisites.The nurses experiencing the interaction with the patient became more dynamic and meaningful, and that their preconception of the patient perspective is put into play.  Data collection on admission will be qualified and the nursing process will be launched on relevant issues.The patients express that they are seen, heard, met and feel more informed.
Conclusion/Application to practice: There will be a follow-up focus group interviewing with the four colleagues.The nurses' skills in MI can be transferred to other aspects of nursing such as basic needs and the conversation when the patient is discharged.

Disclosure: No conflict of interest declared

O 14
Research and patient centred care - the SoLID trial experience
T. Ostapowicz^1
1Renal Medicine, Wellington Hospital, Wellington, New Zealand

Background: New Zealand has one of the highest home-based dialysis patient populations in the world.  Regardless of culture and beliefs, all home dialysis patients value their independence and dialysis is tailored specifically for each individual.
Coordinating the Sodium Lowering In Dialysate (SoLID) trial has highlighted the importance of maintaining a holistic balance to accommodate these diverse patients on home haemodialysis. This trial has many assessments which are time consuming and affects a treatment that these highly motivated patients have adapted to fit their lives.The SOLID study is a research trial implemented in New Zealand to address the high rate of cardiac death in our home dialysis patients. The risk of sudden cardiac death is greater when there is an increase in left ventricular (LV) mass.  Risk factors associated with LV hypertrophy are consistent with elevated BP and fluid overload.  Frequent/ nocturnal dialysis has been previously shown to improve BP and extracellular fluid volumes, with reduction of LV mass.  However, not all patients can manage such a treatment regime at home.
SOLID is a randomised, controlled trial aiming to recruit 118 New Zealand home haemodialysis patients. It compares LV mass index and outcomes of 12 months on low sodium (135mmol/L) versus conventional sodium (140mmol/L) dialysate.Making this trial work has required much flexibility, negotiation and trust.  The patient profiles we will describe illustrate the colourful diversity of each individual situation.

Disclosure: No conflict of interest declared

O 15
Development of a training and education strategy focussing on “education for today and tomorrow”
C. Poole^1
1NephroCare Head Office, Fresenius Medical care, Birmingham, United Kingdom

Background: The need for the development of exemplary renal knowledge and skills for the renal workforce is synonymous with the need to promote staff education and training which in turn has the capacity to have a positive impact and outcome for renal patients.
Objectives:The main objective was to survey employees in order to review the current training provision with the aim of improving training support and developing a new training and education strategy.
Methods: A training questionnaire was distributed to all staff employed in satellite dialysis units for electronic completion using Keysurvey. The questionnaire consisted of 43 questions which varied in design from true/false style, likert style and free text responses. Demographic questions were also included in order to gain an insight into the survey population.
Results:The results were completed online using Keysurvey this allowed timely review of the results, ease of analysis and generation of themed results.The results were collated and used to develop “6 E’s of Education” – Education, Energise, Expertise, Excellence, Enlighten, Enlist.
Conclusion/Application to practice: In conclusion the safe assessment, planning, delivery and evaluation of high quality holistic dialysis care is paramount and forms the foundations of our training and education strategy – the 6 E’s.

Disclosure: No conflict of interest declared

O 16
Haemodialysis patients improved life skills after using the Guidet Self Determination Method
J. Finderup¹, T. Bjerre², A. Nielsen³, M. Nielsen⁴, V. Zoffmann^{5, 6
1}Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark;²Department of Medicine, Roskilde Hospital, Roskilde, Denmark; ³Department of Medicine, Lillebaelt Hospital, Fredericia, Denmark;
⁴University College Metropol, Copenhagen, Denmark; ⁵Steno Diabetes Center, Gentofte, Denmark; ⁶Norwegian center of competency - patient education and learning, Oslo University Hospital, Oslo, Norway

Background: Studies in diabetes have shown that the Guided Self Determination (GSD) method effectively improved patients' glycemic control and life skills with their chronic condition. As a pilot study in 2011 showed promising results of using parts of GSD adjusted to haemodialysis patients, we decided to test a fullscale GSD in haemodialysis patients.
Objectives: To investigate how GSD influenced haemodialysis patients' life skills including their self-management of their condition.
Methods: After GSD was fully adjusted to haemodialysis patients, 20 nurses from five different dialysis units in Denmark went through a certification process each delivering GSD-intervention for two patients. 40 patients thus went through a GSD-intervention lasting four months and comprising six GSD-sessions.
A mixed methods evaluation was conducted analysing semi-structed interviews with 13 patients and clinical data from all participants.
Results: Qualiatively most patients improved their life skills after the GSD-intervention. A patient said: "I have become able to do more than just lying ill" and another patient put it: "I have got other goals and more happiness into my life". Some patients became more involved in their dialysis treatment changing to home-haemodialysis and some obtained better control of their phosfate, potassium, malnutrition and fluid overload.
Conclusion/Application to practice: Some patients recommended that GSD should be delivered to patients as soon as possible after starting dialysis. The results indicate that the GSD method increased life skills in haemodialysis patients and can be recommended in earlier stages of kidney disease. A randomised controlled trail is needed.

Disclosure: No conflict of interest declared