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The Role of the Nephrology Registered Nurse in Home Dialysis in Extended Care Facilities. 肾科注册护士在延续性护理机构家庭透析中的作用。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Donna Painter, Donna Bednarski, Jennifer Vavrinchik, Alice Hellebrand

More and more nursing homes are admitting residents receiving dialysis. In 2023, the Centers for Medicare and Medicare Services released guidance addressing the qualifications of those caring for these residents and further clarified the survey process. The American Nephrology Nurses Association Board of Directors created the Home Dialysis for Nursing Home Residents Task Force to review the revised guidance, investigate strategies and opportunities for nephrology registered nurses in home dialysis therapy in this setting, and consider the potential implications related to alternative home dialysis settings. This article discusses their process, findings, and outcomes.

越来越多的疗养院开始接收接受透析治疗的居民。2023 年,医疗保险和医疗保险服务中心发布了指南,规定了护理这些居民的人员资格,并进一步明确了调查流程。美国肾脏病护士协会董事会成立了养老院居民家庭透析特别工作组,以审查修订后的指南,调查肾脏病注册护士在这种环境下进行家庭透析治疗的策略和机会,并考虑与其他家庭透析环境相关的潜在影响。本文讨论了他们的工作过程、调查结果和成果。
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引用次数: 0
Exploring Loneliness and Burnout in Nephrology Nurses: A Mixed-Methods Analysis. 探索肾脏科护士的孤独感和职业倦怠:混合方法分析。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Rachel E Wood, Amber B Paulus, R K Middle Elswick

Nurse well-being is critical for safe and efficient health care delivery, particularly in complex and demanding specialties like nephrology. However, levels of burnout are rising and may relate to a largely unexplored phenomenon: loneliness. This study investigated the phenomenon of nurse loneliness as a potential factor in burnout. A mixed-methods approach was used to investigate burnout and loneliness in a national sample of nephrology nurses. Together with workforce demographics, burnout and loneliness were measured, prevalence was estimated, and correlations were examined. Interpretive descriptive inquiry and analysis was used to develop a richer understanding of nurse loneliness in the context of burnout. In the study population (n = 217), rates of burnout were low, but positively correlated with loneliness. Qualitative interviews reveal that organizational and systemic pressures, recognition and peer support, work environment and demands, and physical and emotional well-being are components of the experience of current nephrology nurses related to loneliness and burnout.

护士的身心健康对于安全高效地提供医疗保健服务至关重要,尤其是在肾脏病学等复杂且要求高的专科领域。然而,护士的职业倦怠程度正在上升,这可能与一种在很大程度上尚未被研究的现象有关:孤独感。本研究调查了作为职业倦怠潜在因素的护士孤独现象。本研究采用混合方法调查了全国肾内科护士样本中的职业倦怠和孤独感。结合劳动力人口统计数据,对职业倦怠和孤独感进行了测量,估计了发生率,并研究了相关性。通过解释性描述调查和分析,对护士在职业倦怠背景下的孤独感有了更丰富的了解。在研究人群(n = 217)中,职业倦怠率较低,但与孤独感呈正相关。定性访谈显示,组织和系统压力、认可和同伴支持、工作环境和要求以及身心健康是当前肾内科护士与孤独和职业倦怠相关的经历的组成部分。
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引用次数: 0
The Impact of Interdisciplinary Care Teams in Value-Based Kidney Care: Insights from Case Study Reports. 跨学科护理团队在基于价值的肾脏护理中的影响:案例研究报告的启示。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Molly L Cahill, Amber B Paulus

Value-based care (VBC) aims to improve patient health outcomes relative to the cost of care by shifting from traditional fee-for-service models to patient-centered, outcome-driven approaches. This framework is particularly important in nephrology, where high costs associated with chronic kidney disease (CKD) and end stage kidney disease have prompted the adoption of new care models. Key programs such as the Comprehensive End-Stage Renal Disease Care Model and the Kidney Care Choices program have introduced multidisciplinary teams and early-stage CKD interventions to improve patient outcomes and reduce costs. This article highlights the essential role of interdisciplinary collaboration in VBC, with registered nurses, nurse practitioners, pharmacists, social workers, dietitians, and physicians coordinating care to address clinical and non-clinical needs. Case studies demonstrate the effectiveness of coordinated efforts in medication management, patient education, and addressing social determinants of health. These examples underscore the potential for VBC to significantly improve patient outcomes in kidney care while addressing health care inequities and reducing overall costs. Findings emphasize the importance of early interventions, interdisciplinary teamwork, and targeted support for patients with CKD in achieving VBC outcomes.

基于价值的医疗(VBC)旨在通过从传统的收费服务模式向以患者为中心、以结果为导向的方法转变,从而提高患者的医疗效果,降低医疗成本。这一框架在肾脏病学领域尤为重要,慢性肾脏病(CKD)和肾脏病晚期相关的高成本促使人们采用新的护理模式。终末期肾病综合护理模式和肾脏护理选择计划等关键项目引入了多学科团队和早期 CKD 干预措施,以改善患者预后并降低成本。本文强调了跨学科合作在 VBC 中的重要作用,即注册护士、执业护士、药剂师、社会工作者、营养师和医生协调护理,以满足临床和非临床需求。案例研究表明,在药物管理、患者教育和解决健康的社会决定因素等方面的协调工作非常有效。这些实例强调了自愿性肾脏病治疗中心的潜力,即在解决医疗保健不公平问题和降低总体成本的同时,显著改善肾脏病患者的治疗效果。研究结果强调了早期干预、跨学科团队合作以及为慢性肾脏病患者提供有针对性的支持对取得 VBC 成果的重要性。
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引用次数: 0
Maximizing the Impact of Poster Presentations: A Practical Guide for Nephrology Nurses. 最大化海报展示的影响力:肾内科护士实用指南》。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Tara O'Brien, Christine Horvat Davey, Sharon Jackson White, Debbie Horine, Shushanne Wynter-Minott, Annette Hood

Effective poster presentations are important in disseminating research findings, evidence-based practice projects, and quality improvement initiatives to diverse audiences. Posters are widely presented to peers, stakeholders, and the broader community, providing information in a concise, visually appealing format that promotes engagement, knowledge sharing, and collaboration. This article provides a comprehensive guide for poster development for nephrology nurses to disseminate critical insights, promote evidence-based care, and foster knowledge exchange.

有效的海报展示对于向不同受众传播研究成果、循证实践项目和质量改进计划非常重要。海报可广泛展示给同行、利益相关者和更广泛的群体,以简洁、具有视觉吸引力的形式提供信息,促进参与、知识共享和合作。本文为肾内科护士提供了一份全面的海报制作指南,以传播重要见解、推广循证护理和促进知识交流。
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引用次数: 0
Transplant 101: Kidney Transplant Referral and Evaluation. 移植 101:肾移植转诊和评估。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Amy Woodard

Transplant is the preferred treatment option for patients with end stage kidney disease. Patients with kidney disease should be informed about the transplant option, and if appropriate, referred for a transplant evaluation. Early referral is key to getting patients transplanted quicker because the evaluation is extensive and the waiting time on the deceased donor kidney transplant list is years. Understanding the steps in a transplant evaluation process can help providers and staff educate and support their patients through the evaluation process.

移植是终末期肾病患者的首选治疗方案。肾病患者应了解移植手术的选择,并在适当的情况下转诊接受移植评估。早期转诊是让患者更快接受移植的关键,因为评估的范围很广,而在已故捐赠者肾移植名单上的等待时间长达数年。了解移植评估过程的步骤有助于医疗服务提供者和医务人员在评估过程中教育和支持患者。
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引用次数: 0
Preventing Coagulation of Extracorporeal System During Hemodialysis. 在血液透析过程中防止体外系统凝结。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Emmanuel Fatona

Hemodialysis (HD), from the clinical perspective, involves the HD machine, blood lines or tubing, and a dialyzer that mimics the physiologic action of the kidneys to clear the blood of wastes or by-products. A literature review was performed to identify preventative measures of coagulation during HD treatment. EBSCOhost, Academic Search Premier, MEDLINE, and PubMed were used. Seventy-nine (79) related articles were found. Sixty-one (61) were excluded, and 18 were included in the study. Low-dose/unfractionated heparin, low molecular weight heparin(s), airless tubing system, specially formulated dialyzers, continuous saline flushes, and contact activation inhibitor-AB023, combining heparin-coated dialyzers with intermittent saline flushes, are useful preventive measures. It is important to evaluate the individual needs of each patient in making decisions regarding treatment.

从临床角度来看,血液透析(HD)包括血液透析机、血液管路或管道以及透析器,透析器可模拟肾脏的生理功能清除血液中的废物或副产品。我们进行了一项文献综述,以确定在血液透析治疗期间的凝血预防措施。使用了 EBSCOhost、Academic Search Premier、MEDLINE 和 PubMed。共找到 79 篇相关文章。其中 61 篇被排除,18 篇被纳入研究。低剂量/非分馏肝素、低分子量肝素、无气管系统、特殊配方透析器、连续生理盐水冲洗、接触活化抑制剂-AB023(结合肝素涂层透析器和间歇性生理盐水冲洗)是有用的预防措施。在决定治疗方法时,必须评估每位患者的个人需求。
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引用次数: 0
Nephrology Nursing Workforce Challenges: An Opportunity for Innovation. 肾科护理人员面临的挑战:创新机遇。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Nancy Colobong Smith
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引用次数: 0
Beyond the Clinic: How Coaching Elevates Nephrology Nursing Practice. 超越诊所:教练如何提升肾科护理实践。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Julie Ann Lawrence, Lori Harwood

Coaching can enhance individual performance and promote a culture of collaboration and quality in the clinical setting. By utilizing the tools and skills inherent to coaching, individual and team outcomes can be elevated. In this article, an experienced nephrology nurse, who is also a certified coach, describes how the use of a coaching approach in professional development can lead to positive impact on workplace culture, and describes how nephrology nurses and leaders are in a key position to utilize aspects of coaching to enhance team cohesiveness, collaboration, and ultimately, patient outcomes.

教练可以提高个人绩效,促进临床环境中的协作文化和质量。通过利用教练固有的工具和技能,可以提高个人和团队的成果。在这篇文章中,一位经验丰富的肾内科护士同时也是一名认证教练,她描述了在职业发展中使用教练方法如何对工作场所文化产生积极影响,并介绍了肾内科护士和领导者如何处于关键位置,利用教练的各个方面来增强团队凝聚力、协作,并最终提高患者的治疗效果。
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引用次数: 0
Utilizing Telehealth Education for Persons with Chronic Kidney Disease Stages 4-5: Eliminating Barriers at the Patient and Provider Level. 为慢性肾病第 4-5 阶段患者提供远程健康教育:消除患者和医疗服务提供者层面的障碍。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Vicki Montoya, Desiree A Díaz, Gregory E Gilbert

Home dialysis rates have improved little over the past five years. Lack of pre-dialysis patient education persists as an obstacle precluding greater improvement. In this study, barriers to chronic kidney disease (CKD) education at patient and provider levels were addressed using telehealth education for patients with CKD Stages 4-5 in a nonacademic outpatient nephrology practice. A quasi-experimental design was used to compare patients (n = 31) who received telehealth education to those in usual care. CKD Knowledge subscales of kidney function, slowing the progression of CKD, and options for treatment of kidney failure were measured pre-education, post-education, and three months later. There was no significant difference in CKD Knowledge scores over time or in treatment groups. Telehealth CKD education offers flexible options to address patient/provider barriers and potentially improve patient choice of home dialysis therapies.

在过去五年中,家庭透析率几乎没有提高。透析前患者教育的缺乏一直是阻碍透析率进一步提高的障碍。在这项研究中,针对非学术性门诊肾脏内科诊所中的慢性肾脏病(CKD)4-5 期患者,采用远程医疗教育的方式解决了患者和医疗服务提供者层面的慢性肾脏病(CKD)教育障碍。该研究采用准实验设计,将接受远程健康教育的患者(n = 31)与接受常规护理的患者进行比较。在教育前、教育后和三个月后分别测量了肾功能、减缓慢性肾功能衰竭进展和肾衰竭治疗方案等慢性肾功能衰竭知识分量表。不同时间段或不同治疗组的 CKD 知识得分没有明显差异。远程医疗慢性肾脏病教育提供了灵活的选择,可解决患者/医疗服务提供者的障碍,并有可能改善患者对家庭透析疗法的选择。
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引用次数: 0
Received Self-Care Support and Psychosocial Health Among Older Adults with Non-Dialysis-Dependent Chronic Kidney Disease. 非透析依赖型慢性肾病老年患者获得的自我护理支持与社会心理健康。
IF 0.8 4区 医学 Q4 NURSING Pub Date : 2024-09-01
Nicole DePasquale, Jamie A Green, Patti L Ephraim, Sarah Morton-Oswald, Sarah B Peskoe, Jane Pendergast, Teri Browne, C Barrett Bowling, L Ebony Last

Older age is linked with poorer self-care in the chronic kidney disease (CKD) setting. Informal health supporters (family members and friends) are critical sources of self-care support, but much remains unclear about the characteristics and implications of received support among this patient population. We examined how received self-care support (amount and type) related to positive (CKD management self-efficacy) and negative (depressive symptoms) psychosocial health correlates of self-care in 536 adults aged 65 years and older with non-dialysis-dependent CKD. Participants who received a greater amount of support reported less CKD management self-efficacy and more depressive symptoms. We did not observe associations between self-care support type and psychosocial health. Further research is needed to clarify our findings, especially studies that investigate causality and contextual influences.

在慢性肾脏病(CKD)患者中,年龄越大,自我护理能力越差。非正规的健康支持者(家庭成员和朋友)是自我护理支持的重要来源,但对于这类患者所接受的支持的特点和影响仍有很多不清楚的地方。我们研究了 536 名 65 岁及以上非透析依赖型慢性肾脏病成人所获得的自我护理支持(数量和类型)与自我护理的积极(慢性肾脏病管理自我效能)和消极(抑郁症状)社会心理健康相关性的关系。获得支持越多的参与者对慢性肾脏病管理的自我效能感越低,抑郁症状越多。我们没有观察到自我护理支持类型与社会心理健康之间的关联。我们需要进一步的研究来澄清我们的发现,尤其是调查因果关系和环境影响因素的研究。
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引用次数: 0
期刊
Nephrology Nursing Journal
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