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2.
Perit Dial Int ; 39(2): 134-141, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30661004

RESUMEN

BACKGROUND: Peritoneal dialysis (PD) is a home-based therapy where nurses train patients in its use. There has been no published randomized controlled trial (RCT) evaluating any specific protocol for nurses delivering PD training. A standardized education package based upon the best available evidence and utilizing modern educational practices may lead to improved patient outcomes. The aim is to develop a standardized, evidence-based curriculum for PD trainers and patients aligned with guidelines from the International Society for Peritoneal Dialysis (ISPD), using best practice pedagogy. METHODS: A literature search and clinical audit were conducted to identify current practice patterns and best practice. Results were reviewed by a focus group of practitioners comprising PD nurses, nephrologists, consumers, a medical education expert, and an eLearning expert. From this, a training curriculum and modules were developed. RESULTS: A comprehensive PD training curriculum has been developed, which includes modules for training PD nurses (trainers) and patient training manuals. The package comprises 2 introductory modules and 2 clinical case modules. The curriculum is designed for both interactive digital media (trainers) and traditional paper-based teaching with practical demonstrations (patients). Assessment is also addressed. CONCLUSION: The need for the development of a comprehensive and standardized curriculum for PD nurse trainers and their patients was confirmed. This paper outlines the process of the development of this curriculum. Pilot testing of the modules was launched in late 2017 to examine feasibility, and planning has commenced for a RCT in 2019 to investigate the effect of the modules on clinical outcomes, and their wider application across Australia and New Zealand.


Asunto(s)
Personal de Salud/educación , Educación del Paciente como Asunto , Diálisis Peritoneal , Competencia Profesional , Formación del Profesorado , Curriculum , Humanos , Nefrología/educación , Enfermería en Nefrología/educación , Educación del Paciente como Asunto/métodos , Diálisis Peritoneal/normas
3.
Anesth Analg ; 129(1): 121-128, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-29933269

RESUMEN

BACKGROUND: Although continuous renal replacement therapy (CRRT) is common, unplanned interruptions (UI) often limit its usefulness. In many units, nurses are responsible for CRRT management. We hypothesized that a nurse training program based on high-fidelity simulation would reduce the rate of interrupted sessions. METHODS: We performed a 2-phase (training and evaluation), randomized, single-center, open study: During the training phase, intensive care unit nurses underwent a 6-hour training program and were randomized to receive (intervention) or not (control) an additional high-fidelity simulation training (6 hours). During the evaluation phase, management of CRRT sessions was randomized to either intervention or control nurses. Sessions were defined as UI if they were interrupted and the interruption was not prescribed in writing more than 3 hours before. RESULTS: Study nurses had experience with hemodialysis, but no experience with CRRT before training. Intervention nurses had higher scores than control nurses on the knowledge tests (grade, median [Q1-Q3], 14 [10.5-15] vs 11 [10-12]/20; P = .044). During a 13-month period, 106 sessions were randomized (n = 53/group) among 50 patients (mean age 70 ± 13 years, mean simplified acute physiology II score 69 [54-96]). Twenty-one sessions were not analyzed (4 were not performed and 17 patients died during sessions). Among the 42 intervention and 43 control sessions analyzed, 25 (59%) and 38 (88%) were labeled as UI (relative risk [95% CI], 0.67 [0.51-0.88]; P = .002). Intervention nurses required help significantly less frequently (0 [0-1] vs 3 [1-4] times/session; P < .0001). The 2 factors associated with UI in multilevel mixed-effects logistic regression were Sequential Organ Failure Assessment score (odds ratio [95% CI], 0.81 [0.65-99]; P = .047) and the intervention group (odds ratio, 0.19 [0.05-0.73]; P = .015). CONCLUSIONS: High-fidelity simulation nurse training reduced the rate of UI of CRRT sessions and the need for nurses to request assistance. This intervention may be particularly useful in the context of frequent nursing staff turnover.


Asunto(s)
/enfermería , Educación Continua en Enfermería/métodos , Enseñanza Mediante Simulación de Alta Fidelidad , Capacitación en Servicio/métodos , Enfermedades Renales/enfermería , Enfermería en Nefrología/educación , Personal de Enfermería en Hospital/educación , Anciano , Anciano de 80 o más Años , Competencia Clínica , Enfermedad Crítica , Femenino , Francia , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/fisiopatología , Masculino , Admisión y Programación de Personal , Estudios Prospectivos , Factores de Tiempo
4.
Enferm. nefrol ; 21(4): 394-401, oct.-dic. 2018. tab, graf
Artículo en Español | IBECS | ID: ibc-180186

RESUMEN

Introducción: Los profesionales de enfermería de cinco servicios de nefrología recibieron entrenamiento en Entrevista Motivacional mediante un taller de ocho horas centrado en como promover la adhesión al tratamiento en el paciente renal y su familia. El objetivo fue evaluar cambios en: competencia percibida en habilidades comunicativas especificas, respuesta empática espontanea e implantación de las habilidades in vivo medido a través de una rejilla observacional. Material y Método: Diseño pretest-postest sin grupo control. La muestra estaba formada por 46 profesionales del ámbito de la enfermería nefrológica. Resultados: Los resultados muestran cambios en la capacidad percibida de validar al paciente (p<0,031), así como en autorregulación emocional (p<0,014). La respuesta empática espontánea aumentó en los cuatro casos clínicos presentados, pero no llegó a alcanzar significancia estadística (p>0,05). La rejilla observacional, implementada durante el entrenamiento, informó acerca de indicadores de éxito tales como: reducir el tono paternalista, mostrar calma, generar confianza y escuchar de manera activa. Conclusiones: Los resultados son consistentes con otros estudios que evalúan el impacto de los programas de entrenamiento en habilidades de comunicación en nefrología


Introduction: Nursing professionals from five nephrology departments received training in Motivational Interviewing through an eight-hour workshop focused on how to promote adherence to treatment in renal patients and their families. The objective of the present study was to assess changes in: perceived competence in specific communication skills, spontaneous empathic response and readiness to apply in vivo communicative skills measured through an observation grid. Material and Method: Pretest-posttest design without control group. The sample consisted of 46 nephrology nurses. Results: The results show changes in the perceived competence to validate the patient (p<0.031), as well as emotional self-regulation (p<0.014). The empathic spontaneous response increased in the four clinical cases presented, but no statistical significance was reached (p>0.05). The observation grid, implemented during the training, reported on indicators of success such as: reducing the paternalistic tone, showing calm, generating trust and active listening. Conclusions: The results are consistent with other studies that evaluate the impact of communication training programs in nephrology


Asunto(s)
Humanos , Habilidades Sociales , Comunicación en Salud , Enfermería en Nefrología/educación , Entrevista Motivacional/métodos , Evaluación de Eficacia-Efectividad de Intervenciones , Cooperación del Paciente/estadística & datos numéricos , Actitud del Personal de Salud
6.
Br J Nurs ; 27(7): 382-388, 2018 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-29634339

RESUMEN

This article aims to evaluate the evidence relating to the effectiveness of alcohol-based gel for hand sanitising, or 'handrub', in infection control in healthcare settings with particular reference to renal nursing, as this has become pertinent due to the increasing reliance on evidence-based practice. There is a need to implement better infection control strategies and education, to reinforce knowledge among the public, health professionals and those at high risk of infection not only in renal nursing, but also in other areas of practice. Healthcare-associated infections (HCAIs) put patients' safety at risk, increase morbidity and mortality, extend the length of hospital admission and increase the cost to the NHS. There is evidence that the prevalence of HCAIs in England can be minimised through the use of different infection control measures. For example, alcohol-based handrub has been found to be associated with minimising the spread of gastrointestinal infections not only in hospital settings, but also in childcare centres. In addition, the UK national guidelines recommend regular handwashing (implementing the right technique) when hands are visibly dirty and hand disinfection with alcohol-based handrub when they are not visibly dirty. This should be before, in between and after different healthcare activities are performed.


Asunto(s)
Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Desinfección de las Manos/métodos , Desinfectantes para las Manos/uso terapéutico , Control de Infecciones/métodos , Enfermería en Nefrología/educación , Antiinfecciosos Locales/uso terapéutico , Infección Hospitalaria/enfermería , Inglaterra , Etanol/uso terapéutico , Práctica Clínica Basada en la Evidencia , Hospitales , Humanos , Guías de Práctica Clínica como Asunto , Prevalencia , Jabones/uso terapéutico , Resultado del Tratamiento
8.
Enferm. nefrol ; 20(3): 209-214, jul.-sept. 2017. tab, graf
Artículo en Español | IBECS | ID: ibc-166837

RESUMEN

Una de las actividades que se realizan en el proceso educativo con herramientas de ayuda a la toma de decisión (HATD) es ayudarles a explorar sus valores mediante las "tarjetas de valores". El objetivo del estudio fue, conocer los valores de las personas con Enfermedad Renal Crónica en la elección de modalidad de Tratamiento Sustitutivo Renal y analizar si existía relación entre los mensajes de las tarjetas y la modalidad de tratamiento. Estudio retrospectivo. Se incluyeron 281 pacientes que pasaron por el proceso de educación con HATD entre los años 2011-2016. Los datos se obtuvieron de los registros de enfermería de la historia clínica. Se estudiaron variables demográficas, tarjetas de valores y elección de tratamiento. La muestra fue de 281 pacientes. Las 3 tarjetas que obtuvieron un mayor porcentaje de elección fueron, Personal sanitario responsable del tratamiento (14,20%), Ser independiente (13,65%), Impacto para la familia (13,30%); según la modalidad de tratamiento elegida, HD: Impacto para la familia (15,94%), Personal sanitario responsable del tratamiento (15,58%), Ser independiente (13,04%). DP: Ser independiente (18,95%), Personal sanitario responsable del tratamiento (15,26%), Impacto para la familia (14,21%). Tratamiento médico conservador: Ser independiente (25,2%), Autonomía e Impacto para la familia (12,5%). Trasplante de donante vivo: Personal sanitario responsable tratamiento (30%), Ser independiente (30%), Autonomía (10%). Podemos concluir que la mayoría de los mensajes de las tarjetas, parecen estar en concordancia con la modalidad elegida. No hay valores propios de una modalidad de tratamiento sustitutivo renal sino personas con diferentes valores que marcan la toma de decisión (AU)


One of the activities carried out in the educational process with decision support tools (HATD) is to help patients explore their values through "value cards". The aim of the study was to know the personal values of Chronic Kidney Disease patients in the choice of Renal Replacement Treatment modality and to analyze if there was a relationship between the messages of the cards and the modality of treatment. Retrospective study. We included 281 patients who went through the education process with HATD between the years 2011-2016. Data were obtained from nursing records in the medical history. Demographic variables, stock cards and treatment choice were studied. The sample was 281 patients. The three cards that obtained a higher percentage of selection were: health personnel responsible for treatment (14.20%), independent (13.65%) and impact for the family (13.30%). According to the modality of treatment chosen, for hemodialysis patients were: impact for the family (15.94%), health personnel responsible for treatment (15.58%) and independent (13.04%); while for peritoneal dialysis patients, they were: independent (18.95%), health personnel responsible for treatment (15.26%) and impact for the family (14.21%). For those with conservative medical treatment, they were: independent (25.2%), autonomy and impact for the family (12.5%); and for those with live donor transplantation: health personnel responsible for treatment (30%), independent (30%) and autonomy (10%). We can conclude that most of the messages on the cards appear to be in accordance with the modality of treatment. There are no values of a modality of renal replacement therapy, but people with different values that influence in the decision making (AU)


Asunto(s)
Humanos , Diálisis Renal/enfermería , Toma de Decisiones , Enfermería en Nefrología/educación , Enfermería en Nefrología/organización & administración , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/enfermería , Técnicas de Apoyo para la Decisión , Estudios Retrospectivos
10.
Semin Nephrol ; 37(1): 10-16, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-28153189

RESUMEN

Although varying widely among different countries and geographic regions, the development of peritoneal dialysis invariably requires a well-established program. Key ingredients for the successful delivery of this therapy include adequate chronic kidney disease education, governmental or nongovernmental reimbursement, qualified physicians and nurses trained in the principles and practice of peritoneal dialysis, clinical management that incorporates an excellent and well-trained peritoneal dialysis team, a feasible and well-designed program for catheter insertion, a sound patient training and follow-up scheme, and continuous quality improvement. Some programs are enhanced by an active clinical research portfolio and other appropriate supportive systems. All of these factors are interlinked and inseparable from one another in ensuring a high-quality peritoneal dialysis program.


Asunto(s)
Política de Salud , Fallo Renal Crónico/terapia , Enfermería en Nefrología/educación , Nefrología/educación , Grupo de Atención al Paciente/organización & administración , Educación del Paciente como Asunto/organización & administración , Diálisis Peritoneal/métodos , China , Humanos , Educación del Paciente como Asunto/métodos , Desarrollo de Programa , Mejoramiento de la Calidad , Mecanismo de Reembolso , Autocuidado
11.
Vasc Endovascular Surg ; 51(3): 146-148, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28190377

RESUMEN

Early creation of arteriovenous fistulas (AVFs) decreases morbidity and mortality in patients with end-stage renal disease and is the standard of care in the United States. However, this procedure is frequently not accessible in low- and middle-income countries (LMICs). We present the first reported case of successful AVF creation as part of a humanitarian assistance mission. The patient was a 51-year-old male with diabetes, hypertension, and end-stage renal disease on hemodialysis via a temporary dialysis catheter. Preoperative assessment and patient selection were coordinated with the host nation (HN) nephrologist and dialysis team. The visiting surgical team provided education on AVF anatomy, complications, and cannulation techniques to the HN dialysis team. A left brachiocephalic AVF was created under regional anesthesia performed by the visiting surgeon and anesthesiologists. There were no postoperative complications, and the AVF was matured and accessed successfully by the HN dialysis team 7 weeks after creation. Performing AVFs as part of humanitarian assistance missions has the potential to significantly reduce morbidity and mortality in LMICs.


Asunto(s)
Derivación Arteriovenosa Quirúrgica , Conducta Cooperativa , Comunicación Interdisciplinaria , Fallo Renal Crónico/terapia , Medicina Naval , Grupo de Atención al Paciente , Sistemas de Socorro , Diálisis Renal , Navíos , Educación Médica Continua , Educación Continua en Enfermería , Fiji , Humanos , Fallo Renal Crónico/diagnóstico , Masculino , Persona de Mediana Edad , Nefrólogos/educación , Enfermería en Nefrología/educación , Estados Unidos
12.
Enferm. nefrol ; 19(4): 318-329, oct.-dic. 2016. tab, graf
Artículo en Español | IBECS | ID: ibc-159094

RESUMEN

Introducción: La enfermedad renal crónica constituye un problema de salud pública por su elevada incidencia y prevalencia, importante morbimortalidad y coste asistencial. Un aspecto fundamental para el paciente es la elección de modalidad de terapia sustitutiva renal. En este sentido, la consulta de enfermedad renal crónica avanzada o prediálisis, puede jugar un papel fundamental. Objetivo: Conocer producción científica sobre la influencia de la consulta de enfermedad renal crónica avanzada en la elección de modalidad de diálisis por parte del paciente. Metodología: Revisión bibliográfica para la que se realizaron búsquedas en las bases de datos de PubMed, Scielo, Science Direct, Proquest y Google Académico. Se analizaron los artículos que trataban la consulta prediálisis, variables que influyeran en la elección de modalidad de diálisis y satisfacción del paciente. Resultados: Se han revisado 25 artículos publicados en los años 2002-2014, de diseño observacional descriptivo y de cohortes. Se ha encontrado relación en la elección de las técnicas domiciliarias con la existencia de un programa de educación prediálisis, la información que ofrece enfermería, la entrada programada en diálisis, menor edad, menor comorbilidad y factores socioeconómicos o estructurales. Conclusion: Los factores que favorecen la elección de las técnicas de diálisis domiciliarias son la existencia de consulta de enfermedad renal crónica avanzada y la referencia oportuna del paciente a dicha consulta, ser joven, menor comorbilidad y la necesidad de contención de costes. Esta elección se ve perjudicada por factores estructurales. Las terapias domiciliarias producen mayor satisfacción en los pacientes (AU)


Introduction: Chronic kidney disease is a public health problem due to its high incidence and prevalence, important morbidity and mortality, and cost of care. A fundamental aspect for the patient is the choice of modality of renal replacement therapy. In this sense, the consultation of advanced chronic renal disease or predialysis, can play a fundamental role. Objective: To know scientific production on the influence of the consultation of advanced chronic renal disease in the choice of renal replacement therapy modality from the patient perspective. Methodology: Bibliographic review for which the databases of PubMed, Scielo, Science Direct, Proquest and Google Scholar were searched. We analyzed those articles that addressed the pre-dialysis consultation, variables that influenced the choice of dialysis modality and patient satisfaction. Results: We have reviewed 25 articles published in the years 2002-2014, both descriptive observational and cohort design. We have found a relationship in the choice of domiciliary techniques with the existence of a predialysis education program, the information offered by nursing, the programmed entrance into dialysis, younger age, lower comorbidity and socioeconomic or structural factors. Conclusion: The factors facilitating the choice of home dialysis techniques are the existence of advanced chronic kidney disease consultation and the patient’s timely reference to such consultation, being young, reduced comorbidity and the need for cost containment. This choice is hampered by structural factors. Home therapies produce greater patient satisfaction (AU)


Asunto(s)
Humanos , Masculino , Femenino , Insuficiencia Renal Crónica/enfermería , Insuficiencia Renal Crónica/terapia , Selección de Paciente , Satisfacción del Paciente/estadística & datos numéricos , Enfermería en Nefrología/educación , Enfermería en Nefrología/organización & administración , Estilo de Vida , Aceptación de la Atención de Salud , Enfermería en Nefrología/normas , Enfermería en Nefrología/tendencias , Comorbilidad
13.
Nephrol News Issues ; 30(5): 17-8, 20, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27382861

RESUMEN

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.


Asunto(s)
Movilidad Laboral , Certificación , Enfermería en Nefrología/educación , Enfermería en Nefrología/normas , Humanos , Sociedades de Enfermería , Estados Unidos
15.
Urol Nurs ; 36(2): 67-71, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27281862

RESUMEN

This article presents the findings of a pre-test, post-test quality improvement project that describes the change in knowledge from prior to and following an evidence-based education presentation. The presentation addressed the clinical symptoms, diagnostic processes, interventions, and responsibilities of licensed and unlicensed health care workers employed in long-term care facilities related to prevention and detection of non-catheter-related urinary tract infections. Results indicate that the education presentation improved knowledge in specific.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Cuidados a Largo Plazo , Enfermería en Nefrología/educación , Infecciones Urinarias/enfermería , Enfermería Basada en la Evidencia , Humanos , Licencia en Enfermería , Mejoramiento de la Calidad , Encuestas y Cuestionarios , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/prevención & control
17.
Nephrol Nurs J ; 43(2): 93, 98, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27254963

RESUMEN

Professional nephrology nurses are responsible for their ongoing education and competency in their area of practice. ANNA has an additional opportunity for education for nephrology nurses at the 47th National Symposium to be held May 1-4, 2016, in Louisville, Kentucky. The Janel Parker Memorial Opening Session keynote speaker for the meeting will be Suzanne Miyamoto, PhD, RN, Senior Director of Government Affairs and Health Policy with the American Association of Colleges of Nursing. Her topic will be "Are We Practicing to the Fullest Extent? Licensure, Certification, and Education?" This session will help address educational competence in nephrology nursing.


Asunto(s)
Certificación/normas , Competencia Clínica/normas , Educación en Enfermería/organización & administración , Concesión de Licencias/normas , Enfermería en Nefrología/educación , Especialidades de Enfermería/educación , Congresos como Asunto , Humanos , Kentucky , Objetivos Organizacionales
18.
Nephrol Nurs J ; 43(2): 101-7; quiz 108, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27254965

RESUMEN

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.


Asunto(s)
Fístula Arteriovenosa/enfermería , Dietética , Fallo Renal Crónico/enfermería , Enfermería en Nefrología/educación , Enfermería en Nefrología/normas , Guías de Práctica Clínica como Asunto , Diálisis Renal/enfermería , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Educación Continua en Enfermería , Femenino , Anciano Frágil , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
19.
Nephrol Nurs J ; 43(2): 129-38, 148; quiz 139, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27254968

RESUMEN

This qualitative study describes the temporal patterns of fatigue found as part of a larger study designed to elicit a description of the experience and self-management of fatigue for patients on hemodialysis. Two patterns of fatigue were identified. The first pattern, continuous fatigue, was characterized by participants who experienced fatigue at all times, which was their normal, baseline feeling. Within this group, two subgroups were identified. The second pattern of fatigue, post-dialysis fatigue only, was characterized by participants who experienced fatigue only after their hemodialysis session. This study is unique because it expands our knowledge about hemodialysis and fatigue by describing the patterns that fatigue follows over time from one hemodialysis session to the next. Insight into these phenomena could help ameliorate fatigue and allow nurses to tailor interventions for patients on hemodialysis.


Asunto(s)
Fatiga/etiología , Fatiga/enfermería , Enfermería en Nefrología/educación , Personal de Enfermería en Hospital/educación , Diálisis Renal/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Ritmo Circadiano , Educación Continua en Enfermería , Femenino , Humanos , Masculino , Mid-Atlantic Region , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Factores de Tiempo
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