Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00146.X
E. Wittich
As a result of crusty growths over some haemocatheter exit sites, it was decided to explore why these crusty scabs occur and how they could be eradicated. It is concluded that a haemocatheter exit site requires a dressing, which will maintain an optimum environment, and avoid contamination from Staphylococcus aureus. Inadine (Johnson & Johnson) a povidine iodine product, applied before the final dressing of Tielle (Johnson & Johnson Medical), a hydropolymer adhesive dressing creates an ideal environment for healing. The haemocatheter exit site can also be inspected at each dialysis session, but can in fact be left insitu for seven days.
{"title":"Maintaining an optimum haemocatheter exit site.","authors":"E. Wittich","doi":"10.1111/J.1755-6686.2001.TB00146.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00146.X","url":null,"abstract":"As a result of crusty growths over some haemocatheter exit sites, it was decided to explore why these crusty scabs occur and how they could be eradicated. It is concluded that a haemocatheter exit site requires a dressing, which will maintain an optimum environment, and avoid contamination from Staphylococcus aureus. Inadine (Johnson & Johnson) a povidine iodine product, applied before the final dressing of Tielle (Johnson & Johnson Medical), a hydropolymer adhesive dressing creates an ideal environment for healing. The haemocatheter exit site can also be inspected at each dialysis session, but can in fact be left insitu for seven days.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83852288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00141.X
J. Casey
Renal Nursing presents many challenges for nurses seeking to work at advanced level. The ever-changing political climate and increasing service demands make it vital for nurses to grasp the opportunities that advanced practice offers. Theorists have suggested that the over-specialisation of nursing could lead to a fragmented nursing service and an undervaluing of the registered nurse. September 1999 saw the appointment of two such Advanced Nurse Practitioners within the renal unit. This article takes a personal look at the implementation of an Advanced Nurse Practitioner service over the first 12 months and suggests that such a role does have a lot to offer particularly in a renal setting.
{"title":"Advanced nursing practice in renal medicine.","authors":"J. Casey","doi":"10.1111/J.1755-6686.2001.TB00141.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00141.X","url":null,"abstract":"Renal Nursing presents many challenges for nurses seeking to work at advanced level. The ever-changing political climate and increasing service demands make it vital for nurses to grasp the opportunities that advanced practice offers. Theorists have suggested that the over-specialisation of nursing could lead to a fragmented nursing service and an undervaluing of the registered nurse. September 1999 saw the appointment of two such Advanced Nurse Practitioners within the renal unit. This article takes a personal look at the implementation of an Advanced Nurse Practitioner service over the first 12 months and suggests that such a role does have a lot to offer particularly in a renal setting.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75701478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00143.X
J. Andrew
The pre-dialysis experience is a time of change. Individuals and their families are able to adapt to this change and altered lifestyle if their specific needs are met. This qualitative study aims to gain an understanding of the patient's. perspective and identify how they manage the pre-dialysis experience. This knowledge will enable renal unit teams to plan effective holistic programmes, which meet the needs of the individual. The emergent theory identified that pre-dialysis patient's and their families have to accept a different view of life before they can move forward and make a decision regarding treatment. The adoption of a model for good practice aids the transition.
{"title":"The pre-dialysis experience--are individual needs being met?","authors":"J. Andrew","doi":"10.1111/J.1755-6686.2001.TB00143.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00143.X","url":null,"abstract":"The pre-dialysis experience is a time of change. Individuals and their families are able to adapt to this change and altered lifestyle if their specific needs are met. This qualitative study aims to gain an understanding of the patient's. perspective and identify how they manage the pre-dialysis experience. This knowledge will enable renal unit teams to plan effective holistic programmes, which meet the needs of the individual. The emergent theory identified that pre-dialysis patient's and their families have to accept a different view of life before they can move forward and make a decision regarding treatment. The adoption of a model for good practice aids the transition.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88242293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00142.X
C. Wilde, J. Macefield
Examination of the patient experience within our unit, from pre dialysis through to establishment of dialysis in the community identified that the care was fragmented. To improve patient care, a change process was initiated. Four home care teams comprising three qualified nurses and one renal care assistant were established with each team responsible for a caseload of patients within a specified geographical location. To measure the impact on the patient, 100 questionnaires were circulated after twelve months. Results from 60 patients showed 76% of pre dialysis patients and 80% of dialysis patients were very satisfied with the change process. The main advantage of this change for the patient is that they are in a continuous supportive cycle for all their non-inpatient care throughout their replacement therapy. We conclude that patient focused care is essential and should be a transition catalyst in a change resistant environment.
{"title":"Improvement in care: a collaborative approach to rehabilitation.","authors":"C. Wilde, J. Macefield","doi":"10.1111/J.1755-6686.2001.TB00142.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00142.X","url":null,"abstract":"Examination of the patient experience within our unit, from pre dialysis through to establishment of dialysis in the community identified that the care was fragmented. To improve patient care, a change process was initiated. Four home care teams comprising three qualified nurses and one renal care assistant were established with each team responsible for a caseload of patients within a specified geographical location. To measure the impact on the patient, 100 questionnaires were circulated after twelve months. Results from 60 patients showed 76% of pre dialysis patients and 80% of dialysis patients were very satisfied with the change process. The main advantage of this change for the patient is that they are in a continuous supportive cycle for all their non-inpatient care throughout their replacement therapy. We conclude that patient focused care is essential and should be a transition catalyst in a change resistant environment.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77383208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00149.X
N. Nakahara, T. Nakatani, Y. Takemoto, T. Kishimoto
In Japan, the number of patients seeking kidney transplants has declined in recent years. To investigate the reasons for this decline, a questionnaire was given to 73 haemodialysis patients treated at the Tokiwa-Tatsumi Clinic. The resulting data showed the percentage of patients seeking transplants declined from 61% in 1992 to 19.2% in 1999. The reasons given for not seeking transplants were the improvements of physical condition and resultant quality of life (QOL) due to progress in dialysis therapy, upgraded social welfare support, uncertainties of transplant medicine, loss of expectations due to limited availability of transplant kidneys and aging of patients. Meanwhile, the number of patients on dialysis continues to increase by approximately 10,000 a year, and the mean age of patients rises. To reduce this number, greater effort must be directed toward preventive medical care as well as educating the public regarding transplant medicine.
{"title":"Japanese patients not seeking kidney transplants.","authors":"N. Nakahara, T. Nakatani, Y. Takemoto, T. Kishimoto","doi":"10.1111/J.1755-6686.2001.TB00149.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00149.X","url":null,"abstract":"In Japan, the number of patients seeking kidney transplants has declined in recent years. To investigate the reasons for this decline, a questionnaire was given to 73 haemodialysis patients treated at the Tokiwa-Tatsumi Clinic. The resulting data showed the percentage of patients seeking transplants declined from 61% in 1992 to 19.2% in 1999. The reasons given for not seeking transplants were the improvements of physical condition and resultant quality of life (QOL) due to progress in dialysis therapy, upgraded social welfare support, uncertainties of transplant medicine, loss of expectations due to limited availability of transplant kidneys and aging of patients. Meanwhile, the number of patients on dialysis continues to increase by approximately 10,000 a year, and the mean age of patients rises. To reduce this number, greater effort must be directed toward preventive medical care as well as educating the public regarding transplant medicine.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78718514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00151.X
G. Hartley
Low protein diets (LPD), providing < or = 0.6 g protein/kg body weight daily, have traditionally been used in the nutritional management of chronic renal failure (CRF). Initially they were advocated when dialysis availability was limited. More recently LPD have been proposed as a means of delaying the rate of CRF progression. Despite much research in this area, the value of protein restriction remains contentious. A major concern over their use is that they may induce malnutrition. This is of critical importance since mortality rates are significantly increased in individuals who are malnourished when dialysis is initiated. Other approaches to the nutritional management of CRF may be more appropriate. The primary goal of any nutritional therapy should be to optimise the patient's nutritional status. In the UK LPD are used in a minority of units. An alternative approach to the use of these diets is to view the prevention of malnutrition as being of paramount importance. For uraemic patients, dialysis is the best treatment.
{"title":"Nutritional status, delaying progression and risks associated with protein restriction.","authors":"G. Hartley","doi":"10.1111/J.1755-6686.2001.TB00151.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00151.X","url":null,"abstract":"Low protein diets (LPD), providing < or = 0.6 g protein/kg body weight daily, have traditionally been used in the nutritional management of chronic renal failure (CRF). Initially they were advocated when dialysis availability was limited. More recently LPD have been proposed as a means of delaying the rate of CRF progression. Despite much research in this area, the value of protein restriction remains contentious. A major concern over their use is that they may induce malnutrition. This is of critical importance since mortality rates are significantly increased in individuals who are malnourished when dialysis is initiated. Other approaches to the nutritional management of CRF may be more appropriate. The primary goal of any nutritional therapy should be to optimise the patient's nutritional status. In the UK LPD are used in a minority of units. An alternative approach to the use of these diets is to view the prevention of malnutrition as being of paramount importance. For uraemic patients, dialysis is the best treatment.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91197276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-06DOI: 10.1111/J.1755-6686.2001.TB00145.X
P. Lunts
Home therapies are increasingly being demonstrated to be the best treatments for the early stages of the dialysis life-cycle. Although home haemodialysis has declined dramatically over the last 20 years from 41% in 1983 (1) to 3.2% in 1998 in the UK alone (2), many studies have suggested that it offers the optimum dialysis in terms of outcomes (3,4,5). Evidence from a 1998 survey of UK dialysis staff indicates that the major perceived drawbacks of home haemodialysis were lack of suitable patients, family stress, cost of machines and training time (6). The study also strongly indicated that a lack of familiarity with the treatment was a major cause of its decline in many units. We set out to redesign our approach to home haemodialysis to make it suitable for many more patients.
{"title":"21st century home haemodialysis: a new approach to an old treatment.","authors":"P. Lunts","doi":"10.1111/J.1755-6686.2001.TB00145.X","DOIUrl":"https://doi.org/10.1111/J.1755-6686.2001.TB00145.X","url":null,"abstract":"Home therapies are increasingly being demonstrated to be the best treatments for the early stages of the dialysis life-cycle. Although home haemodialysis has declined dramatically over the last 20 years from 41% in 1983 (1) to 3.2% in 1998 in the UK alone (2), many studies have suggested that it offers the optimum dialysis in terms of outcomes (3,4,5). Evidence from a 1998 survey of UK dialysis staff indicates that the major perceived drawbacks of home haemodialysis were lack of suitable patients, family stress, cost of machines and training time (6). The study also strongly indicated that a lack of familiarity with the treatment was a major cause of its decline in many units. We set out to redesign our approach to home haemodialysis to make it suitable for many more patients.","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80256238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"29th EDTNA/ERCA Conference. European Dialysis and Transplant Nurses Association European Renal Care Association. Lisbon, Portugal, 8-11 July 2000. Abstracts.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21853291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C Gilding, J Goodeve, S Metcalf, S Smith, D Anderson, J Natali, H Warwick, J Kay, S Carr
This article looks at the implementation of shared governance at directorate level and its role in improving vascular access catheter care.
这篇文章着眼于共享治理在董事会层面的实施及其在改善血管导管护理中的作用。
{"title":"The utilisation of shared governance to improve vascular access catheter care.","authors":"C Gilding, J Goodeve, S Metcalf, S Smith, D Anderson, J Natali, H Warwick, J Kay, S Carr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article looks at the implementation of shared governance at directorate level and its role in improving vascular access catheter care.</p>","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21672123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper argues that the role of the nephrology nurse goes far beyond the generally accepted parameters of technical expert to include the roles of care giver, advocate, educator, facilitator, mentor and referral agent. Patients with End Stage Renal Disease, who require long term dialysis, experience many stressors which they must cope with in order to achieve an acceptable quality of life. Nephrology nurses who understand the stress of living with dialysis, and who are familiar with the coping strategies a patient may use, are ideally placed to facilitate the process of adaptation from the patient and their families perspective.
{"title":"Nephrology nursing practice: more than technical expertise.","authors":"K J Ran, C Hyde","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper argues that the role of the nephrology nurse goes far beyond the generally accepted parameters of technical expert to include the roles of care giver, advocate, educator, facilitator, mentor and referral agent. Patients with End Stage Renal Disease, who require long term dialysis, experience many stressors which they must cope with in order to achieve an acceptable quality of life. Nephrology nurses who understand the stress of living with dialysis, and who are familiar with the coping strategies a patient may use, are ideally placed to facilitate the process of adaptation from the patient and their families perspective.</p>","PeriodicalId":79589,"journal":{"name":"EDTNA/ERCA journal (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21672120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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