Nx2me Connected Health^®

Background
During a therapy session, a care partner attempted to increase the patient’s RF volume from 25L to 30L but pushed an incorrect button accidentally. Since the care partner did not know whether the rate or volume had been adjusted, they wisely chose to contact NxStage technical support.

Action
A NxStage Tech Support rep took the call and utilized a Nx2me Link Session to view the cycler data stream. This allowed him to see and confirm the exact volume and rates that had been programmed, as well as the data that had already been processed prior to the pause in treatment.

Impact
Using Nx2me Link’s timely and accurate data, the tech support rep was able to calculate and adjust the cycler therapy to within 1L of the specific volume goal. With the Nx2me Link Session and NxStage Tech Support guiding the way, the care partner made the adjustment. Nx2me has shown to improve patient retention by monitoring compliance, early intervention and education.¹

• 29% Lower Therapy discontinuation rate due to controllable causes
• 1 Week Reduction in median training time

Background
A NxStage patient was experiencing lightheadedness and nausea and reached out to the center for assistance. The nurse assessed the patient over the phone and recognized symptoms of hypotension related to volume removal, then instructed her to administer saline and lie back with her feet elevated. The patient began to feel better, but the nurse wanted to review her treatment record via the Nx2me Clinician Portal to ensure she hadn’t missed anything.

Nurse Action
After arriving at the clinic, the nurse used the Nx2me Clinician Portal to compare data on the flow sheet with data from the patient. She discovered the patient had been taking steroids and gained weight, which required increasing her recorded dry weight. Adjustments were quickly made, which helped the patient get back on the right course of treatment.

Patient Impact
If not for the Nx2me Clinician Portal, three weeks would have passed before the patient’s next physician clinic visit, and this critical data would not have been seen until then. Nx2me enabled fast, easy access to precise and up-to-date patient treatment information, which positively impacted clinical decision-making, patient safety, and satisfaction.

Background
A Home Training nurse received a call from a nephrologist about a new Home Hemodialysis (HHD) trainee he was sending over. The patient had a history of non-adherence when they were on peritoneal dialysis (PD) and was, at that very moment, in the hospital for treatment of complications brought on by a month­long lapse in exchanges. The nephrologist was confident this patient would be great for HHD and training was scheduled.

A Pleasant Surprise
As it turned out, the nephrologist was correct. After three weeks of HHD training, the patient and spouse began using the Nx2me app on an iPad and quickly became comfortable with the technology. They were extremely adherent with their HHD training, missed zero sessions, and were sent home after completing the training.

Patient Impact
Since the patient completed training and was sent home, they have only missed one treatment. The visibility that their care team had to their treatments via the Nx2me Clinician Portal encouraged them to remain adherent with their prescription.

Background
A lung transplant patient who weighs just 39 kg is known to her home nurse for being very sensitive to fluid gains. Her clearance is more than adequate but keeping fluid gains under control is very difficult.

Action
Using the Nx2me Clinician Portal, the nurse consulted Nx2me flow sheets and a report helping her identify that the patient often performed extra treatments solely for ultrafiltration. Once this information was uncovered, the patient’s treatment times were adjusted to keep her fluid under tight control.

Impact
With adjustments made to treatment frequency and time, the patient no longer needs additional treatments for ultrafiltration. Additionally, the patient was given parameters so she can make adjustments on her own. Thanks to Nx2me and a forward-thinking nurse, the patient and her care team are all experiencing new levels of satisfaction!

Background
Two newly trained Home Hemodialysis (HHD) patients were experiencing low blood pressure, and a home training RN from their clinic took note via the Nx2me Clinician Portal.

Nurse Action
Hypotension red flag alerts in Nx2me Clinician Portal prompted the nurse to dig deeper, and she noticed a correlation between the records. Both red flags occurred around the second month the patients were at home, and data showed that both patients were symptomatic at their estimated dry weight. The RN investigated the matter and learned that since starting HHD at home, the two patients had...

• Stopped taking antihypertensive medication
• Increased their activity levels
• Increased their muscle mass and dry weight

Realizing their health status had changed for the better, the nurse collaborated with the nephrologist and dry weights for both patients were increased.

Nx2me Impact
Since this adjustment, both patients have experienced fewer episodes and their dry weights are more accurate. Their alert nurse now has a new best practice – each day she uses Nx2me Connected Health to evaluate all HHD patients for clinical indicators. What’s more, her proactive routine has been adopted by the center, and it is now a required daily process for the Home Training Nurse to review and approve all patient flow sheets before they are entered into the electronic medical record.

Background
A Home Training Nurse, reviewing records on Nx2me Connected Health, noticed that a couple of patients were occasionally missing their home hemodialysis (HHD) treatments, specifically on weekends. It appeared to be a case of non-adherence.

Action
The social worker, nephrologist and home training nurse had conversations with one of the patients and discovered that the patient’s care partner was overburdened – trying to balance the responsibilities of a job and helping administer HHD. A multidisciplinary team met to discuss the situation and identify solutions that would allow the patient to continue dialyzing at home.

Impact
Meeting with the patient and care partner separately, the social worker, physician and home nurse used Nx2me Clinician Portal data to help explain concerns about missed treatments. Solo HHD was an option proposed as a way to maintain the patient’s home therapy while reducing the caregiver’s hardships. One patient is now being trained to do Solo HHD and the second patient is considering trying Solo HHD therapy as well!

Not only was the multidisciplinary team able to retain a patient, they were also able to decrease a care partner’s burden, bringing relief to everyone involved!