Acute Nephrology Nurse Managers and Medical Directors: The Roles and Relationships to Produce Quality in the Unit.

Nurse managers and medical directors play integral roles in ensuring the delivery of high-quality care. Nurse managers oversee day-to-day operations, coordinating staffing, patient care, and resource allocation. They are responsible for fostering a supportive environment for nursing staff while upholding standards of excellence in patient care. Medical directors bring their clinical expertise and leadership, guiding treatment protocols and ensuring adherence to best practices. Together, nurse managers and medical directors form a dynamic partnership in which collaboration is paramount. By synergizing their respective strengths, nurse managers and medical directors can optimize patient outcomes, streamline processes, and drive continuous improvement initiatives. Effective communication and mutual respect are foundational to this collaboration because they work hand-in-hand to navigate complex medical challenges and uphold standards of excellence. In this symbiotic relationship, the ultimate goal is to produce quality care that enhances patient well-being and satisfaction.

Nurse Manager's Guide to Life Safety Code for Dialysis Facilities.

The importance of the Life Safety Code (LSC) cannot be understated. The LSC is composed of a set of components, measures, and protocols with the overarching goal of protecting and preserving human life. This article describes the LSC survey process in dialysis facilities. Ensuring the physical plant and its infrastructure is critical for patient safety. The survey tasks, provider, and building management responsibilities are reviewed. Implications for nephrology nursing regarding survey readiness and best practices for an LSC survey are discussed.

[Improvement of the pre-examination phase of medical biology exams at the Henri Mondor University Hospitals: a pilot study]. / Une étude pilote pour l'amélioration de l'étape pré-analytique des examens de biologie médicale pris en charge au sein des hôpitaux universitaires Henri Mondor.

The medical and university department of biology pathology at Henri Mondor hospital in Créteil has been engaged in an NF EN ISO 15189 accreditation process since 2014. One of the elements of this process concerns the quality of handling of samples and their transportation to laboratories, including the implementation place requires fighting against pre-examination non-conformities, which are the source of many dysfunctions. The pre-examination group has implemented several actions in a targeted care service. Thanks to these, the rate of non-conformities has halved in 18 months. In parallel, a work project targeting student nurses on internship was born to follow up on the results of a statistical study carried out by the pre-examination group on non-conformities. The objective of the project was to include nursing students on internship in a full support course on good sampling practices and pre-analytical non-conformities. This was based on the realization of two knowledge quizzes (before and after training), theoretical training, and visits to several laboratories. This study lasted 10 months with the participation of 37 students. The results showed a marked improvement in knowledge of pre-analytics as well as total satisfaction of all students. Our approach has helped to better understand the needs of laboratories and demonstrates the usefulness of training students in good sampling practices in order to ensure better patient care as well as an improvement in their comfort and well-being.

Nephrology Nursing Scope and Standards of Practice: Integration into Clinical Practice.

The eighth edition of the Nephrology Nursing Scope and Standards of Practice, published by the American Nephrology Nurses Association (Gomez, 2017), defines the scope of nephrology nursing practice, and provides standards of practice and professional performance in an approach similar to the American Nurses Association (ANA) 2016 standards. ANNA's eighth edition of the Nephrology Nursing Scope and Standards of Practice incorporates competencies for graduate level-prepared nurses in addition to the registered nurse (RN) and advanced practice registered nurse (APRN). The section on how to use the standards in practice has been updated with user-friendly forms. This article provides an overview of the scope of practice, standards, competencies, and situations that require intervention by the nephrology nurse.

Emphasizing the Value of Nephrology Nursing Through Nursing-Sensitive Indicators: A Call for Action.

Nursing is the largest healthcare profession in the United States (U.S.). As principal frontline caregivers in the U.S. healthcare system, nurses have tremendous influence over a patient's healthcare experience. A growing body of evidence states that the nursing workforce has a direct impact on healthcare quality. A standardized approach to measuring nursing's contribution to patient care and safety using nursing-sensitive quality indicators assists in examining the extent to which nurses and nursing affect the quality and safety of health care. This article focuses on nursing-sensitive quality indicators and discusses healthcare quality indicators and nursing-sensitive indicators used in the U.S. A summary of the work of the American Nephrology Nurses' Association Task Force on Nephrology Nursing-Sensitive Quality Indicators (NNSQI) and an NNSQI exemplar are provided.

Education, certification, and professional membership can help with career goals.

For the professional nephrology nurse, the interplay of certification, education, and professional association membership go hand-in-hand. The association provides the foundation, networking, and educational opportunities; certification validates skills and expertise; and education challenges and inspires the nurse to keep moving forward.

Relationship Between Age and Pre-End Stage Renal Disease Care in Elderly Patients Treated with Maintenance Hemodialysis.

Receipt of pre-end stage renal disease (ESRD) clinical care can improve outcomes for patients treated with maintenance hemodialysis (HD). This study addressed age-related variations in receipt of a composite of recommended care to include nephrologist and dietician care, and use of an arteriovenous fistula at first outpatient maintenance HD. Less than 2% of patients treated with maintenance HD received all three forms of pre-ESRD care, and 63.3% received none of the three elements of care. The mean number of pre-ESRD care elements received by the oldest group (80 years and older) did not differ from the youngest group (less than 55 years), but was less than the 55 to 66 and 67 to 79 years groups; adjusted ratios of 0.93 (0.92 to 0.94; p < 0.001) and 0.94 (0.92 to 0.95; p < 0.001), respectively. A major effort is needed to ensure comprehensive pre-ESRD care for all patients with advanced chronic kidney disease (CKD), especially for the youngest and oldest patient groups, who were less likely to receive recommended pre-ESRD care.

Hemodialysis Catheter Care: Identifying Best Cleansing Agents.

In an attempt to create a standardized resource for cleansing both non-tunneled and tunneled hemodialysis catheters, it was discovered that all disinfectants are not compatible with all catheters. This article describes the process used to identify best practices for hemodialysis catheter care and steps taken to standardize practice throughout a hospital network. Standardized evidence-based practice preserves the integrity of catheters while allowing nurses to provide quality care to patients.

What nurses need to know about female genital mutilation.

Female genital mutilation, also known as female circumcision (FGM/C) is a deep-rooted practice in some countries that needs to be addressed if the health needs of women and girls are to be met. FGM/C has no medical or health benefits. This article will discuss the different types of FGM/C, the law and legal implications and urological complications. Urology nurses need to be aware of what their medical roles and legal responsibilities are so that they are able to sensitively and holistically care for girls and women living with or at risk of FGM/C.

Management of incontinence-associated dermatitis with a skin barrier protectant.

The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinence-associated dermatitis (IAD). IAD is skin breakdown related to faecal and/or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage.

Cancer management: the difficulties of a target-driven healthcare system.

This article gives a reflective overview on cancer management from a urological perspective. It is based on anecdotal evidence and observations of local practice, and highlights some of the inherent difficulties of delivering a robust service in a target-driven healthcare system. Cancer is a complex disease. It is crucial that stringent measures are used to ensure those affected by it receive care that is of the highest quality, delivered in a timely manner, and tailored to meet the individual's needs. In 2000, the Government's attempt to increase competition among healthcare providers in the delivery of care, and thereby healthcare quality and efficiency, resulted in a number of healthcare reforms being introduced in the UK. Central to these were the NHS Cancer Waiting Time standards, which were designed to fast-track care delivery in the management of cancer patients. The multidisciplinary teams play a pivotal role in this process and their contribution is imperative to achieving the desired outcomes. It is acknowledged that targets can be beneficial, but there are clear unintended consequences as well. Increases in urgent referrals result in significant screening demands and, consequently, newly diagnosed cancers. This, combined with factors such as patient choice and costs, put added pressure on NHS establishments and health professionals to deliver care within the target specifications.

Health Literacy: Perceptions and Experiences of Pediatric Nephrology Interprofessional Team Members.

Health literacy is an important factor in health care quality. This study examined health literacy perception and health literacy experience of a convenience sample of pediatric nephrology interprofessional team members. Results indicated that the majority of pediatric nephrology interprofessional team members understand the need for health literacy and want to learn about health literacy, but have limited experience with health literacy. This study provides knowledge that can be used to develop, promote, and enhance best practices related to health literacy among pediatric nephrology interprofessional team members.

Pediatric Renal Transplantation.

Pediatric patients with end stage renal disease (ESRD) are not as prevalent as adults with ESRD, but the numbers are increasing each year. Medical management is the same for pediatric patients as it is with adults with ESRD: hemodialysis, peritoneal dialysis, no therapy, or transplantation. Among most pediatric nephrology centers, the goal for patients is to achieve transplantation.