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1.
J Nephrol ; 34(5): 1385-1386, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34596884
2.
Ann Palliat Med ; 10(8): 8701-8708, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34488359

RESUMO

BACKGROUND: There is a lack of data on drug-related problems (DRPs) occurring in nephrology department in China. The objective of this study was to identify and categorize the types and causes of DRPs and to assess their severity. DRPs were examined by clinical pharmacists and the results of their interventions were rated. METHODS: Clinical pharmacists reviewed all medication orders for patients and documented clinical pharmacy services within a nine-month study period. The Pharmaceutical Care Network Europe (PCNE) classification (Version 9.00) was used to identify DRPs. Our Primary outcomes measured the number, causes, types, potential hazards of DRPs and the types and success rate of intervention. RESULTS: Admission medication reconciliation data of 113 patients with chronic kidney disease (CKD) were collected and all of the medications were reviewed retrospectively. Exclude 26 patients who did not occurred DRPs, 87 patients (77%) identified 101 DRPs. The average DRP number per patient was 1.16. The most common type of problem was "treatment effectiveness P1" (84.16%; 85/101). The most common causes were "drug selection C1" (36.00%; 45/125), "dose selection C3" (29.60%; 37/125), and "patient related C7" (26.40%; 33/125). Clinical pharmacists totally proposed 249 interventions, of which 190 (76.31%) were fully accepted and implemented. CONCLUSIONS: DRPs are common among CKD patients in the nephrology department. Hence the necessity for pharmaceutical care to be improved to ensure the ongoing safety of patients.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Nefrologia , Preparações Farmacêuticas , Humanos , Farmacêuticos , Estudos Retrospectivos , Centros de Atenção Terciária
4.
G Ital Nefrol ; 38(4)2021 Aug 30.
Artigo em Italiano | MEDLINE | ID: mdl-34469083

RESUMO

About 60% of the world population has access to the Internet in 2021, making it the main tool in fostering communication between people. Lately, digital information and communication have especially taken place on platforms known as Social Media (SoMe) or Social Networks. In the last decade the usefulness of these tools in carrying information aimed at updating professionals in Medicine and Nephrology has become evident. There are several examples of SoMe utilization in Nephrology, as demonstrated by the existing accounts or Pages operated by the main international nephrological Scientific Societies, or the most renowned specialized medical journals. Twitter, Facebook and YouTube are the most versatile SoMe for these objectives; however, other platforms such as Tik Tok, Linkedin, Instagram, and WhatsApp may serve the same purpose. This digital revolution in disseminating information has proved very useful during the recent COVID-19 pandemic, even though some inappropriate uses have emerged, such as the diffusion of fake news, which has favored the emergence of "adverse effects" or a surge of antiscientific positions. In this review, we examine how physicians and nephrologists can take advantage of digital information for their continuing education. We quote the main resources in the international scenario and illustrate some specific national examples, such as the Journal Club of the Nephrology post-graduate program of the University of Milan and the Facebook group "Medical and Nephrology Community".


Assuntos
Educação Médica Continuada/métodos , Nefrologia/educação , Mídias Sociais , COVID-19/epidemiologia , Humanos , Disseminação de Informação/métodos , Acesso à Internet/estatística & dados numéricos , Itália , Pandemias
5.
BMC Nephrol ; 22(1): 301, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493246

RESUMO

BACKGROUND: Globally, renal healthcare practitioners provide intensive and protracted support to a highly complex multi-morbid patient population however knowledge about the impact of COVID-19 on these practitioners is extremely limited. OBJECTIVE: This study aimed to explore the experiences of COVID-19 with renal healthcare practitioners during the first global lockdown between June 2020 and September 2020. METHODS: A multi-methods approach was carried out including a quantitative survey and qualitative interviews. This was a multinational study of renal healthcare practitioners from 29 countries. Quantitative: A self-designed survey on COVID-19 experiences and standardised questionnaires (General Health Questionnaire-12; Maslach Burnout Inventory). Descriptive statistics were generated for numerical data. Qualitative: Online semi-structured interviews were conducted. Data was subjected to thematic analysis. Renal healthcare practitioners (n = 251) completed an online survey. Thirteen renal healthcare practitioners took part in semi-structured interviews (12 nurses and 1 dietician). RESULTS: The majority of participants surveyed were female (86.9 %; n = 218), nurses (86.9 %; n = 218) with an average 21.5 (SD = 11.1) years' experience since professional qualification, and 16.3 years (SD = 9.3) working in renal healthcare. Survey responses indicated a level of preparedness, training and satisfactory personal protective equipment during the pandemic however approximately 40.3 % experienced fear about attending work, and 49.8 % experienced mental health distress. The highest prevalence of burnout was emotional exhaustion (35.9 %). Three themes emerged from the qualitative analysis highlighting the holistic complexities in managing renal healthcare, a neglected specialist workforce, and the need for appropriate support at work during a pandemic. CONCLUSIONS: Results have highlighted the psychological impact, in terms of emotional exhaustion and mental health distress in our sample of renal healthcare practitioners. As the pandemic has continued, it is important to consider the long-term impact on an already stretched workforce including the risk of developing mental health disorders. Future research and interventions are required to understand and improve the provision of psychological support for specialist medical and nursing personnel.


Assuntos
COVID-19/epidemiologia , Saúde Global , Nefrologia/estatística & dados numéricos , Pandemias , Adulto , Idoso , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , COVID-19/terapia , Competência Clínica/estatística & dados numéricos , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermagem em Nefrologia/economia , Enfermagem em Nefrologia/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Doenças Profissionais/psicologia , Equipamento de Proteção Individual , Angústia Psicológica , Pesquisa Qualitativa , Recursos Humanos
6.
Trials ; 22(1): 612, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503563

RESUMO

BACKGROUND: Globally, over 1.2 million people die from chronic kidney disease (CKD) every year. Patients with CKD are up to 10 times more likely to die prematurely than progress to kidney failure requiring kidney replacement therapy. The burden of symptoms and impaired quality of life in CKD may be compounded by comorbidities and treatment side effects. However, patient-important outcomes remain inconsistently and infrequently reported in trials in patients with CKD, which can limit evidence-informed decision-making. The Standardised Outcomes in Nephrology - Chronic Kidney Disease (SONG-CKD) aims to establish a consensus-based core outcome set for trials in patients with CKD not yet requiring kidney replacement therapy to ensure outcomes of relevance to patients, caregivers and health professionals are consistently reported in trials. METHODS: SONG-CKD involves four phases: a systematic review to identify outcomes (domains and measures) that have been reported in randomised controlled trials involving adults with CKD who do not require kidney replacement therapy; stakeholder key informant interviews with health professionals involved in the care of adults with CKD to ascertain their views on establishing core outcomes in CKD; an international two-round online Delphi survey with patients, caregivers, clinicians, researchers, policy makers and industry representatives to obtain consensus on critically important outcome domains; and stakeholder consensus workshops to review and finalise the set of core outcome domains for trials in CKD. DISCUSSION: Establishing a core outcome set to be reported in trials in patients with CKD will enhance the relevance, transparency and impact of research to improve the lives of people with CKD. TRIAL REGISTRATION: Not applicable. This study is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database: http://www.comet-initiative.org/Studies/Details/1653 .


Assuntos
Nefrologia , Insuficiência Renal Crônica , Adulto , Técnica Delfos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Qualidade de Vida , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Terapia de Substituição Renal , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
8.
BMJ Open ; 11(8): e047923, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34348951

RESUMO

OBJECTIVES: Training strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions. DESIGN: Purposive design and a modified Delphi method to build consensus. SETTING: The department of nephrology in a university hospital in Aichi Prefecture, Japan. PARTICIPANTS: Based on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD <1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated. RESULTS: An initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure. CONCLUSIONS: The concept of EPAs enabled us to develop goals and evaluation criteria for residents' training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.


Assuntos
Internato e Residência , Nefrologia , Competência Clínica , Educação Baseada em Competências , Técnica Delfos , Hospitais , Humanos , Japão
9.
Nephrol Nurs J ; 48(4): 347-365, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34463464

RESUMO

Serious hemodialysis therapy complications are venous needle dislodgement and access-bloodline separation. In 2020, the American Nephrology Nurses Association (ANNA) brought together a task force to update the information and resources developed by the 2012 ANNA Venous Needle Dislodgement Task Force along with the development of additional resources, if needed. The 2020-2021 ANNA Venous Needle Dislodgement Task Force conducted a literature review, requested information from ANNA members, and tested taping techniques. This article discusses the results of the literature review, information requests, and taping technique testing, and provides resources on venous needle dislodgement and access-bloodline dislodgement, along with practice recommendations.


Assuntos
Agulhas , Nefrologia , Humanos , Diálise Renal
10.
Nephrol Nurs J ; 48(4): 413-417, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34464045

RESUMO

The COVID-19 pandemic began with uncertainty in how to care for patients and protect staff. The American Nephrology Nurses Association (ANNA) immediately recognized the need to provide its members and others in the nephrology community with as much information as possible. Resources were collected and disseminated in many forms (e.g., publications, webinars, virtual conference sessions). As COVID-19 surges began occurring across the country and staffing reached a crisis level, ANNA collaborated with other organizations to find potential solutions. One solution developed by ANNA was the ANNA COVID-19 Surge Support Process and Map - a process to connect the areas in high need with skilled and available staff. This article describes the ANNA COVID-19 Surge Support Process and Map, which has continued to help address COVID-19 staffing challenges.


Assuntos
COVID-19 , Nefrologia , Humanos , Pandemias , SARS-CoV-2 , Recursos Humanos
11.
Pol Merkur Lekarski ; 49(292): 311-315, 2021 Aug 16.
Artigo em Polonês | MEDLINE | ID: mdl-34464375

RESUMO

The kidney is an organ that maintains the body's sodium and water balance and plays a significant role in blood pressure regulation. Chronic kidney disease (CKD) and a progressive loss of its function, among others, leads to sodium and water retention and, as a consequence, to arterial hypertension. The supply of salt and fluids delivered with the diet significantly affects the cardiovascular system's functioning particularly in hemodialysis patients. The critical element in clinical care is maintaining appropriate water and electrolyte homeostasis. Overhydration is manifested as oedema and blood preassure increase, but a more accurate assessment of subtle variations is possible by measuring bioelectric impedance (BIA), which determines the extracellular water index (ECW). Actions to maintain euvolemia include limiting sodium and fluid intake, regular assessment of "dry" body weight, proper selection of ultrafiltration (UF), correction of sodium concentration, and dialysate temperature.


Assuntos
Nefrologia , Sódio , Impedância Elétrica , Humanos , Diálise Renal/efeitos adversos , Água , Equilíbrio Hidroeletrolítico
12.
Nephrol Nurs J ; 48(4): 311-423, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34463462
13.
Exp Clin Transplant ; 19(7): 651-658, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34325623

RESUMO

OBJECTIVES: COVID-19 has emerged as a global pandemic with significant impacts on health care systems. The present study was conducted to analyze the effects of the COVID-19 pandemic on nephrology and transplant services and clinical training at our center. MATERIALS AND METHODS: This observational study was conducted at the Institute of Kidney Disease and Research Centre (Ahmedabad, India). Our institute is one of the largest tertiary care centers of its kind in India with around 400 total inpatient beds for nephrology, urology, and transplant patients. In 2019, our center had annual outpatient and inpatient numbers of 132 181 and 7471, respectively, and conducted 412 renal transplant procedures. For this study, monthly data on number of outpatients, inpatients, and patients undergoing renal transplant, as well as various nonelective procedures, conducted in 2019 and 2020 were collected and analyzed. We investigated the impact of the COVID-19 pandemic on various non-COVID-19-related health care facilities and on clinical training and research activities at our institute. RESULTS: During the 2020 COVID-19 period, the number of outpatients and inpatients was greatly reduced compared with data from 2019. A similar decrease was seen in patients undergoing hemodialysis, renal transplant, and nonelective procedures at our center. The COVID-19 period also greatly affected clinical training of residents enrolled at our institute and research activities, as a result of focus on COVID-19 as a priority. CONCLUSIONS: The effects of reduced numbers of outpatients and inpatients on workflow, as well as reduced numbers of renal transplants and nonelective procedures on the health of our patients, are unknown. Hence, a strategic scheme is needed to develop new health care models that can help manage the COVID-19 pandemic at present and any further waves arising in the future.


Assuntos
COVID-19 , Atenção à Saúde , Nefropatias , Transplante de Rim/estatística & dados numéricos , Nefrologia/educação , COVID-19/epidemiologia , Humanos , Índia/epidemiologia , Nefropatias/terapia , Estudos Prospectivos
15.
Nephrol Nurs J ; 48(3): 241-249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34286934

RESUMO

Nephrology nurses are not immune to the effects of a stressful work environment. As a result, their emotional and psychological health can be at risk. In addition, there has been unprecedented stress and uncertainty working as nephrology nurses during the pandemic. These stressors can have negative effects on nurses' health, resulting in burnout and/or compassion fatigue, which can lead to nurses leaving nephrology or the nursing profession. Mindfulness has been suggested as a strategy to mitigate work-related stressors and build a more resilient workforce. Our experience suggests that combining self-compassion practices with mindfulness is also effective. Mindfulness may be beneficial for nephrology nurses, but its use does not negate the need for organizations to address the structural system issues that also contribute to burnout.


Assuntos
Esgotamento Profissional , Atenção Plena , Nefrologia , Enfermeiras e Enfermeiros , Resiliência Psicológica , Esgotamento Profissional/prevenção & controle , Empatia , Humanos
16.
Nephrol Nurs J ; 48(3): 253-259, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34286936

RESUMO

This study examines the association between burnout and organizational commitment in nephrology nurses working in hemodialysis. A cross-sectional study of all nurses working in a hospital hemodialysis unit was conducted. Low to medium level of burnout and a high level of organizational commitment were documented. A significant negative correlation was found between burnout and organizational commitment. Burnout was significantly higher among nurses who had made a career shift in the past, and lower levels of burnout were documented among married nurses. In a multivariate analysis, lower levels of burnout and a higher number of children were significantly associated with higher organizational commitment. Burnout is a negative independent predictor for organizational commitment. Inter ventions focused on reducing burnout among nurses should be implemented to improve organizational commitment.


Assuntos
Esgotamento Profissional , Nefrologia , Enfermeiras e Enfermeiros , Criança , Estudos Transversais , Humanos , Satisfação no Emprego , Cultura Organizacional , Inquéritos e Questionários
17.
Semin Nephrol ; 41(3): 253-261, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34330365

RESUMO

Across the world, challenges for clinicians providing health care during the coronavirus disease 2019 (COVID-19) pandemic are highly prevalent and have been widely reported. Perspectives of provider groups have conveyed wide-ranging experiences of adversity, distress, and resilience. In understanding and responding to the emotional and psychological implications of the pandemic for renal clinicians, it is vital to recognize that many experiences also have been ethically challenging. The COVID-19 pandemic has prompted rapid and extensive transformation of health care systems and widely impacted care provision, heightening the risk of barriers to fulfillment of ethical duties. Given this, it is likely that some clinicians also have experienced moral distress, which can occur if an individual is unable to act in accordance with their moral judgment owing to external barriers. This review presents a global perspective of potential experiences of moral distress in kidney care during the COVID-19 pandemic. Using nephrology cases, we discuss why moral distress may be experienced by health professionals when withholding or withdrawing potentially beneficial treatments owing to resource constraints, when providing care that is inconsistent with local prepandemic best practice standards, and when managing dual professional and personal roles with conflicting responsibilities. We argue that in addition to responsive and appropriate health system supports, resources, and education, it is imperative for health care providers to recognize and prevent moral distress to foster the psychological well-being and moral resilience of clinicians during extended periods of crisis within health systems.


Assuntos
COVID-19 , Nefropatias/terapia , Princípios Morais , Nefrologia , Estresse Ocupacional/etiologia , Angústia Psicológica , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Idoso de 80 Anos ou mais , Temas Bioéticos , Atenção à Saúde/ética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nefrologia/ética
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