Impact of coronavirus disease (COVID-19) on home dialysis: Experiences of home dialysis nurses in Australia and Canada

Objective The spread of the coronavirus disease (COVID-19) pandemic has created an opportunity to re-evaluate and refine existing models of healthcare delivery for patients receiving dialysis at home. This study aims to explore the experiences of home dialysis nurses during the pandemic. Methods This was an observational study via survey. Participants were recruited through the home dialysis nursing networks in Australia and the province of Ontario, Canada. Results A total of 45 nurses responded to the survey, 53% (n=24) from Australia and 47% (n=21) from Ontario, Canada. The nurses identified that most units had moved to 'virtual' patient visits, only seeing those patients with urgent issues in person. They also reported problems with delivery of supplies for patients, implementation of social distancing during training, difficulties for patients with navigation of telehealth platforms for `virtual' clinic visits, and staffing shortages with staff needing to stay home with any suspected COVID-19 symptoms or contact. The nurses perceived that being flexible in their roles and working hours were helpful during the pandemic, while being ready to adapt at short notice was also important. Conclusion During the COVID-19 pandemic, patients receiving home dialysis have benefited from fewer healthcare facility visits and a greater ability to adhere to social distancing measures, thus limiting exposure to COVID-19 infection. Yet, patients may face challenges relating to delay or back order of dialysis supplies and social isolation, and may struggle with telehealth platforms. Our learning experience from this pandemic will help us identify the challenges encountered and measures taken to address them.