Nephrology Nursing Journal最新文献

Amid the current health care crisis, organizations must find strategies to ensure high-quality patient care while enabling all nursing levels (licensed practical nurse [LPN]/licensed vocational nurse [LVN], registered nurse [RN], and advanced practice registered nurse [APRN]) to practice to their full scope. Patients undergoing dialysis have complex needs, yet RN shortages have led to incomplete nursing tasks and compromised outcomes. LPNs/LVNs, who make up about 16% of the nursing workforce, deliver essential care that differs from RN/APRN roles. Each nursing role is governed by state-defined scope of practice. In dialysis, understanding the LPN/LVN scope is vital to ensure safe and efficient patient care and avoid inappropriate task delegation. RNs are accountable for delegation, making it essential they delegate appropriately. Strengthening collaboration and communication among nursing roles can improve both patient outcomes and workplace satisfaction.

Patients in the intensive care unit (ICU) are at increased risk of developing hospital-acquired pressure injuries (HAPrIs) due to various factors. Immobility, severity of illness, and medical interventions place these patients at higher HAPrI risk. Patients with acute or chronic kidney conditions receiving intermittent hemodialysis are at an increased risk of HAPrI development due to illness severity and the toll hemodialysis takes on an individual's body. Data from a publicly available database were used in a retrospective study to examine characteristics of 457 older adult (>= 60 years) patients undergoing hemodialysis, including 86 (19%) who developed a HAPrI during their ICU admission. Significant findings show the association of sepsis, diabetes, and smoking with increased HAPrI risk. Findings underscore the need for vigilant monitoring and proactive management of these high-risk patients to improve patient outcomes.

Depression prevalence rates are high in individuals with end stage kidney disease treated with hemodialysis. However, nephrology nursing knowledge about the care of patients with depression is not well studied. The purpose of this review was to explore the knowledge nephrology nurses utilize in the care of patients on hemodialysis who are living with depression. We performed an exploration of MEDLINE, EMBASE, PsychINFO, CINAHL, Cochrane Central Register of Controlled Trials, and Scopus to identify eligible studies. Nine studies were included, and we determined that nephrology nurses' knowledge is informed by the nursing process, primarily in assessment and intervention/ management, with minimal explicit description of theory in hemodialysis and depression care.

Home dialysis offers significant benefits in terms of patient quality of life, autonomy, and cost-effectiveness, yet adoption remains low due to substantial educational, logistical, and structural barriers. Augmented reality (AR) and live virtual support present a promising solution to improve patient education, enhance provider training, and offer real-time remote assistance. This article explores current barriers to home dialysis adoption, the role of AR in overcoming these challenges, and the neuroscience behind effective learning. By integrating AR with evidence-based learning science, we propose a model for more effective home dialysis education that could reduce dropout rates and improve patient retention. We also examine key implementation considerations, including cost, provider responsibility, and reimbursement mechanisms. Early applications of AR in dialysis training, such as guiding ICU staff on new devices, suggest a growing recognition of its value. Future research should assess the impact of AR on skill acquisition, long-term retention, patient confidence, and cost-effectiveness to inform broader implementation strategies.

The lack of nephrology nurses in the present workforce and projected for the future workforce has been documented in the literature. Contributing to this crisis is the near absence of clinical rotations for nursing students in a dialysis unit. In an effort to address the staffing need, the author created, marketed, and negotiated a dialysis curriculum for BSN students at a school of nursing where the author became the faculty for the rotation. Components of the experience consisted of lecture, patient interview, and written report of the clinical findings. In the two years since the creation of the dialysis rotation, the reception from students and dialysis unit staff has been overwhelmingly positive, and has exposed nursing students to nephrology and the benefits of a student membership in the American Nephrology Nurses Association.

The Centers for Medicare and Medicaid Services (CMS) ensures that patients and clinicians are well-informed about various aspects of care, policies, and procedures. CMS has specific guidelines, resources, and requirements to improve patient outcomes and health care delivery. Specifically, the End Stage Renal Disease Conditions for Coverage Interpretive Guidance for dialysis facilities requires training staff and patients on specific topics. Patient education requirements include the right to tailored education, emergency preparedness training, and requirements for the education of patients dialyzing at home. CMS also requires training for staff working in dialysis facilities. Topics for training of staff include infection control, emergency preparedness, and water and dialysate procedures.