Anemia management protocols in the care of hemodialysis patients: Examining patient outcomes.

The role of hemodialysis nurses in renal anemia management has evolved through the implementation of nurse-driven protocols. Using the Nursing Role Effectiveness Model, this case control study examined a nurse-driven renal anemia management protocol approach in contrast to a physician-driven approach to assess patient outcomes and costs of renal anemia management from two comparable hemodialysis centres. Both protocol and control groups achieved target hemoglobin levels between 110-120 g/L. In the protocol group, 75% of patients reached TSAT>20% versus 25% in the control group. Iron costs were $17,000 higher in the control group over the study period. The protocol group used more epoetin alfa, trending upwards to approximately 10,000 units per person by the end of the study with over $8 000 per person higher costs compared to the control group. Evaluation of standardized dosing in renal anemia treatment is suggested for patients with diabetes or cardiac co-morbidities. --P.ii.