30 Day Rehospitalization Risk in Hemodialysis Patients

"Within 96 hours of hospital discharge an Nurse Practitioner will perform a checklist guided assessment to preventing rehospitalizations. The assessment consists of the following:~1. The participants's hospital course will be reviewed and their clinical recovery and stability assessed.~2. Determination of the participants's estimated dry weight (EDW).~3. The participants's post discharge medications will be checked, compared to the prehospitalization medication, and discrepancies will be reviewed and corrected.~4. Blood tests will be ordered for the participants's first return dialysis treatment if medically appropriate after clinical assessment.~5. Write new dialysis orders.~6. Dialysis Access- review access and determine any changes required in treatment"