Nephrology Nursing Journal最新文献

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.

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.

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.

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.

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.

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.

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.

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.

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.