Ms Rosie Simmonds1
1Barwon Health, Geelong, Australia
Biography:
Rosie Simmonds is a Nurse Practitioner in the Renal Service at Barwon Health, University Hosptial Geelong. She has worked in Renal Nursing for “a very long time” ( 4+ decades) with over over 30 years in home dialysis. She is a strong advocate for home haemodialysis and in particular longer hour and more frequent therapy.
Abstract:
Background: Global demand for renal replacement therapy (RRT) continues to rise, including across Australia and New Zealand. Paradoxically, the proportion of patients undertaking haemodialysis in their own homes has steadily declined and is now at its lowest level in decades. This trend is concerning, particularly given that New Zealand and Australia are seen as international leaders in home haemodialysis and widely regarded as exemplars of best practice. Substantial evidence associates home haemodialysis with improved survival, better blood pressure control, reduced cardiovascular risk, and enhanced quality of life compared with facility-based haemodialysis. Declining utilisation raises important questions about sustainability, workforce expertise, and future patient access to this highly effective therapy.
Case Description: This presentation will review the evolution of home haemodialysis in Australia and New Zealand and examine contemporary trends using registry and service-level data. Factors influencing uptake will be explored, including patient education, training models, staffing capacity, skill mix, risk perception, and organisational culture within renal services.
Discussion: Strategies to strengthen and revitalise home haemodialysis programs will be discussed, highlighting the critical role that renal nurses play in patient advocacy, education, workforce capability, and service redesign.
Conclusion: If home haemodialysis outcomes remain superior yet utilisation continues to fall, critical questions must be asked. Renal nurses are central to sustaining and growing home haemodialysis. Strengthening nursing leadership, education, and system support is essential to ensure this high-value modality remains a viable and accessible option for future patients.