Nephrology Nursing Journal : Journal of the American Nephrology Nurses' Association

The outpatient dialysis setting presents unique challenges in the medication process. Dialysis staff conduct all steps in the medication process, including transcribing and verifying orders, preparing and administering medications, and monitoring for therapeutic and adverse effects. When addressing best medication practices, consideration should be given to education and resources provided to staff. This article explores the multiple strategies taken by a national dialysis network to support clinical staff and improve patient safety...

Patients with end stage kidney disease (ESKD) face challenges in comprehending and pursuing available treatment options, particularly with the rising interest in home-based dialysis. Providers struggle to deliver effective, individualized, and cost-efficient training, leading to lower adoption and retention rates. Cannulation, machine use, and safety training remain significant barriers. Using learning science - the marriage of psychology and the neuroscience of learning - we show that interactive virtual reality (IVR) can address these barriers to home dialysis success by providing the experiential learning necessary for deeper understanding and increased competence...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Central venous catheter-related infection is the most common complication in patients on hemodialysis. Nursing care is essential for its maintenance, minimizing risk factors, and avoiding complications, such as bacteremia. A systematic review was conducted to identify the influence of nursing care on the prevention of bacteremia due to hemodialysis catheter. The primary endpoint was the bacteremia rate measured as number of events per 1000 catheter days. The rate of bacteremia in the studies ranged from 0.2 to 5...

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major postoperative complication that results in significant morbidity and mortality. Causes are heterogeneous, treatment strategies are largely supportive, and data on outcomes, such as potential for recovery, are lacking. This literature review explores the evidence on how furosemide may alter the course and outcome of postoperative fluid overload in patients with CSA-AKI. Nephrology nurse practitioners need to employ tailored preventive therapies at the preoperative, intraoperative, and postoperative points of care...

Low attendance by patients with advanced chronic kidney disease (CKD stage 4 and 5) to the kidney replacement therapy (KRT) education sessions was noted by our nurse practitioners at a safety net hospital. The main outcome measure was the weekly percentage of patients with advanced CKD seen by the nephrology division weekly that completed KRT education. Process measures were weekly KRT session attendance by scheduled patients and the weekly referral of patients to KRT education sessions. The weekly education class attendance by scheduled patients reached the target level...

This article describes observations and findings related to infection prevention and control in dialysis facilities. Ensuring infection control best practices is critical for patient safety. Survey findings related to hand hygiene, disinfection practices, medication preparation and administration, central venous catheter management, and hepatitis B surveillance are reviewed. Implications for nephrology nursing in each scenario are discussed, including survey guidance for COVID-19 post-pandemic.

Studies suggest that the hemodialysis (HD) shift on which a patient dialyzes impacts sleep disorders, depressive symptoms, quality of life, and mortality. However, study findings have been limited and inconsistent. The purpose of this project was to determine the relationship between HD shifts (morning, afternoon, and evening), and depression and sleep quality disturbance. Forty-one participants were recruited to participate in this project. Participants on the third shift had the highest levels of depression ( M = 11...

Depression is a common mental health concern among patients with chronic kidney disease. This population has a higher prevalence of hospitalization than those without depression. Exercising during dialysis, specifically intra dialytic pedal cycling, as an intervention can improve patients' overall well-being and promote a better quality of life both mentally and physically.

Fifty years ago, in July 1973, providing care to patients with end stage kidney disease changed dramatically with the implementation of legislation (PL 92-603) that deemed chronic renal disease to be a disability and provided coverage under Medicare for the treatment of the disease. In this article, we discuss the impact of the implementation of PL 92-603.

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No abstract text is available yet for this article.

The American Diabetes Association (ADA) recently published their 2023 standards of care for diabetes, which include a new section with standard of care guidelines to assist clinicians in managing and preventing chronic kidney disease (CKD) and related complications in patients with diabetes. The newly added Section 11, Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes - 2023, makes a number of screening and treatment recommendations for patients with diabetes who are at an increased risk of developing CKD...

Initiating a research protocol into any health care setting requires planning to ensure the research is conducted safely and efficiently, and will yield accurate data. An understanding of basic research principles is essential in this process. One agency that provides Good Clinical Practice guidelines for research is the International Council for Harmonization. This agency mandates Insti tutional Review Board (IRB) oversight for all studies that involve human subjects. The IRB ensures the research design and protocol protect the rights, welfare, and safety of human subjects, as well as appropriate data collection...

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The aim of this qualitative study was to identify nursing processes of care that help keep patients successfully on home hemodialysis (HHD). A qualitative descriptive approach using appreciative inquiry was used as the framework for data collection and analysis. Four focus groups were held with HHD nursing teams in the Province of Ontario, Canada. Results suggest that successful HHD teams have highly performing nurses who work cohesively as a team, and have consistent structures and processes in place for patient education and follow up...

This article describes survey observations and findings related to water and dialysate in hemodialysis facilities. Ensuring the quality of the water and dialysate is critically important for patient safety. Survey findings related to monitoring of the pH and conductivity, microbiology and disinfection, water system monitoring, water in the home dialysis setting, and quality assessment and performance improvement are reviewed. Implications for the nephrology registered nurse in each of the scenarios are discussed...

Nurses are crucial to the health care workforce, yet their well-being is often overlooked, adversely affecting patient care. This article examines the intersection of loneliness and burnout among nephrology nurses, and its impact on their well-being and job performance. Loneliness, defined as inadequate social connections, is identified as a significant contributor to burnout and suboptimal well-being among nurses. Findings emphasize the importance of addressing loneliness and promoting social connectedness within the nursing profession...