RESUMO
Peritoneal dialysis transfer sets (extension lines) are replaced every six to nine months to minimize peritoneal dialysis catheter complications. The aim of this study was to compare a revised non-bag transfer set exchange procedure with the standard bag exchange procedure on nursing time, costs, and safety. Thirty-three people were randomized to two groups - a standard bag exchange procedure group (n = 16) and a non-bag transfer set exchange procedure group (n = 17). The standard bag exchange procedure took a median of 32 minutes (interquartile range [IQR] 25 to 38 minutes) compared to the non-bag transfer set exchange procedure of 6 minutes (IQR 4 to 8 minutes) (p Ò 0.0001). There was one episode of peritonitis in each group within the 72-hour follow-up period. The average cost of the non-bag transfer set exchange procedure was $24.54 lower, a 37% cost reduction. This study has shown the revised non-bag transfer set replacement procedure appears to be safe, consume less participant and staff time, and decreases costs.
Assuntos
Diálise Peritoneal/métodos , Diálise Peritoneal/enfermagem , Cateterismo/efeitos adversos , Custos e Análise de Custo , Humanos , Pesquisa em Avaliação de Enfermagem , Diálise Peritoneal/efeitos adversos , Diálise Peritoneal/economia , Peritonite/etiologia , Peritonite/prevenção & controle , Resultado do Tratamento , Carga de Trabalho/estatística & dados numéricosAssuntos
American Nurses' Association/organização & administração , Competência Clínica/normas , Educação Continuada em Enfermagem/organização & administração , Educação Profissionalizante/organização & administração , Enfermagem em Nefrologia/normas , Sociedades de Enfermagem/organização & administração , Humanos , Papel do Profissional de Enfermagem , Objetivos OrganizacionaisRESUMO
A strong emphasis on self-management for health maintenance in a variety of chronic diseases has been shown to benefit patients' outcomes and quality of life. However, little has been published on such programs in patients with chronic kidney disease. We studied the feasibility and effectiveness of the Chronic Disease Self-Management Program (CDSMP) in 14 patients with ESRD undergoing conventional hemodialysis. This program is designed to enhance skills in the areas of medical, emotional, and role management. Outcome measures in health status, self-management behaviors, self-efficacy, and health care utilization were evaluated through use of questionnaires at baseline and after six months.
Assuntos
Educação de Pacientes como Assunto , Diálise Renal , Insuficiência Renal Crônica/terapia , Autocuidado , Autoeficácia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Inquéritos e Questionários , Estados Unidos , Adulto JovemRESUMO
Dry weight has most frequently been defined by the patient becoming symptomatic when fluid removal is attempted Hypervolemia and fluid removal require ongoing evaluation and the use of a number of strategies. This article reviews strategies for removing fluid during hemodialysis, hemodynamics of fluid removal, and interventions associated with the strategies for fluid removal.
Assuntos
Líquidos Corporais/metabolismo , Falência Renal Crônica/enfermagem , Diálise Renal/métodos , Intoxicação por Água/prevenção & controle , Volume Sanguíneo/fisiologia , Peso Corporal/fisiologia , Educação Continuada em Enfermagem , Hemodinâmica/fisiologia , Humanos , Falência Renal Crônica/complicações , Guias de Prática Clínica como Assunto , Diálise Renal/efeitos adversos , Ultrafiltração , Intoxicação por Água/etiologiaAssuntos
Conhecimentos, Atitudes e Prática em Saúde , Hemodiálise no Domicílio , Falência Renal Crônica/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal , Inquéritos e Questionários , Adulto JovemRESUMO
Pre-dialysis education is known to impact modality choice among patients with end stage renal disease, but many of these patients report a lack of education in alternative dialysis therapies. Since 2004, Satellite Healthcare, a non-profit dialysis provider, has implemented chronic kidney disease education through Options classes at WellBound Centers, resulting in 23% of patients being treated with home therapies. The Satellite Healthcare-WellBound experience confirms that Options classes and a compelling infrastructure for home dialysis therapies are vital elements to bring alternative dialysis therapies to more patients.
Assuntos
Serviços de Assistência Domiciliar , Diálise Renal , Educação Continuada , Humanos , Falência Renal Crônica/terapiaRESUMO
Alternative dialysis therapies offer options for improving the dialysis care and lives of patients. This article reviews the available therapies and presents patient-related reasons for offering these therapies. It is through these therapies that we can make a positive difference for patients.
Assuntos
Falência Renal Crônica/terapia , Diálise Renal/métodos , HumanosRESUMO
This article describes cannulation events, especially problems, common and rare, minor and major, to aid the nephrologist (and mid-level providers e.g. nurse practitioner and physician's assistant) in decision-making to prevent or treat cannulation-related adverse outcomes. The usual management, potential outcomes, nephrologist intervention, and prevention are discussed and include: assessment of arteriovenous (AV) access and readiness for cannulation; initial cannulation of both arteriovenous fistulas and grafts; needle size and adequacy; needle direction and potential for recirculation; limited cannulation sites/buttonhole; pain and fear of pain; prevention of bleeding; management of infiltrations/extravasations; prevention and management of "one-site-itis"; prevention and management of infection. It concludes with the importance of the medical director as the leader of the continuous quality improvement (CQI) team in preventing/reducing cannulation-related adverse events.
