We are better together: nurses' ability to affect change.

The Institute of Medicine has challenged nurses in recent years to practice to the fullest extent of their training and education. This article demonstrates application of this concept by use of example. It describes the processes that a group of nephrology nurses without graduate education who work in direct patient care followed to decrease the rate of transfusion reactions in clients undergoing apheresis receiving fresh frozen plasma fluid replacement.

A review of hemodialysis vascular access devices: improving client outcomes through evidence-based practice.

The number of clients with end-stage renal disease and acute kidney injury requiring kidney replacement therapy is at an all-time high. At the end of 2010, the number of persons in the United States with end-stage renal disease totaled 594,374. Because the majority of clients select hemodialysis, understanding best-practice techniques to prevent infection is paramount. The purpose of this article is to review best-practice recommendations for care of the 3 major vascular access devices used for hemodialysis, with a particular focus on infection prevention recommendations. Implications for infusion nurses are also discussed.