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From mid-March 2020, the pandemic caused by COVID 19 has placed health facilities in front of the need to implement a rapid and profound reorganization. However, many hospitals have not had time to organize a rapid and effective response, both for the speed of spread of the virus, and for the lack of previous experience with a pandemic of this magnitude. With the aim of assessing the knowledge and adoption of the procedures and recommendations disseminated by hospitals during the COVID-19 pandemic, in the dialysis and hemodialysis services of Italian centers, a cross-sectional survey was designed by the Society of Nurses in Nephrology (SIAN). The online survey was conducted among nurses who work in the Italian services of dialysis and hemodialysis during the first and second waves. The online survey was completed by 150 nurses. Although hospitals have set up protocols and procedures for patient management during the COVID-19 pandemic, among participants not all were aware of it. With regard to the training of personnel in the use of personal protective equipment, 18.6% declared that they have not received it. The majority implemented specific precautions for patient management, awareness and information.

n 2017, thanks to an initiative of IPASVI College (the Order of Nursing Professionals of the province of Bologna) in response to 2014 legislations referring to the Guidelines about Chronic Kidney Disease (CKD), nephrology professionals and members of EDTNA/ERCA Italian Branch Association (which in 2018 became Società Infermieri Area Nefrologica, SIAN) in 2021 were requested to contribute to define the role and skills performed by nurses on a daily basis. The management of the CKD patient has been structured into 7 phases: the model for each phase takes into consideration the professionals involved, the care settings and the tools used. To support this approach, we decided to introduce two elements which broaden the clinical and care approach to the patient and at the same time highlight the contribution of nursing professionals, with a referring workflow for the CKD patient, the nurses’ role and skills required throughout the patient’s journey. Furthermore, to ensure the best continuity of care, we believe that it is necessary to apply a logical model based on the principles of early recognition of health and welfare needs; guarantee the most appropriate healthcare response; ensure early care; standardize the procedures of professionals to improve the quality of life of the patient and manage the social and economic impact.

Coronavirus disease 2019 is an infectious respiratory syndrome caused by the virus called SARS-CoV-2, belonging to the family of coronaviruses. The first ever cases were detected during the 2019-2020 pandemic. Coronaviruses can cause a common cold or more serious diseases such as Middle Eastern Respiratory Syndromes (MERS) and Severe Acute Respiratory Syndrome (SARS). They can cause respiratory, lung and gastrointestinal infections with a mild to severe course, sometimes causing the death of the infected person. This new strain has no previous identifiers and its epidemic potential is strongly associated with the absence of immune response/reactivity and immunological memory in the world population, which has never been in contact with this strain before. Most at risk are the elderly, people with pre-existing diseases and/or immunodepressed, dialyzed and transplanted patients, pregnant women, people with debilitating chronic diseases. They are advised to avoid contacts with other people, unless strictly necessary, and to stay away from crowded places, also observing scrupulously the recommendations of the Istituto Superiore di Sanità. In this article we detail the recommendations that must be followed by the nursing care staff when dealing with chronic kidney disease patients in dialysis or with kidney transplant patients. We delve into the procedures that are absolutely essential in this context: social distancing of at least one meter, use of PPI, proper dressing and undressing procedures, frequent hand washing and use of gloves, and finally the increase of dedicated and appropriately trained health personnel on ward.

Introduction: Several observational studies showed that the button hole technique is easy to apply, fast, with a reduction in the formation of hematomas, scars and pain perception. Anyway, other studies showed that the button hole technique has been associated to an increase of the risk of infection, with high rates of infection incidence in arterio venous fistula (AVF) site and septicemia, compared to a rope ladder technique. Objective: The aim of this study is to test the use of a dressing with release of silver ions, for the reduction of the infection incidence rate and the pain symptomatology in patients on hemodialysis with AVF cannulation by button hole technique. Materials and Methods: A prospective, regional, multicenter, randomized pilot study, with balanced allocation 1: 1, with parallel-groups, controlled with standard care group. Results: A solid experimental protocol which can be used as a model for RCT pilot studies which have the objective to study the impact of a dressing for the reduction of the infection incidence rate and pain symptomatology. Conclusions: This pilot study can produce results and trends for the structuring of a subsequent national and multicenter RCT. This model can be used in other similar clinical settings for an evidence-based research approach. (nursing)

IntroductionSeveral observational studies showed that the button hole technique is easy to apply, fast, with a reduction in the formation of hematomas, scars and pain perception. Anyway, other stud...

SUMMARYBackground Few studies have focused on the effect of music in patients undergoing haemodialysis. Objectives To determine the effects of live saxophone music on various physiological parameters and pain, mood and itching levels. Design A randomised controlled study with 114 patients undergoing haemodialysis with a control group (n = 57) and an experimental group (n = 57) who received 30 minutes of live saxophone music therapy. Measurements Systolic and diastolic blood pressure, pulse rate, glycaemia, oxygen saturation, pain, mood and itching levels were measured before and after the live music performance, resulting in baseline and post-test values for the patients in the experimental group. Results The experimental group showed a statistically significant reduction in pain level, and an improvement in mood and itching levels and in the oxygen saturation. Conclusion Live saxophone music could be introduced to improve clinical and quality-of-life measures in patients undergoing haemodialysis.

L’articolo esprime la posizione attuale dell’associazione EDTNA/ERCA Filiale Italiana rispetto al dibattito sulle competenze infermieristiche avanzate – o specialistiche - in atto nella comunità medico-sanitaria nazionale. Facendo riferimento al modello ISFOL, come strumento della definizione delle competenze nel mondo del lavoro, nel territorio europeo ed oltre, il modello viene declinato per il mondo sanitario ed ulteriomente capillarizzato per le aree di assistenza infermieristica nefrologica. Il modello riconosce competenze di base, competenze di settore, trasversali e specifiche. Attraverso questo percorso, da generico e a specifico, vengono riconosciute 6 aree specifiche di assistenza nefrologica (ambulatorio, degenza, dialisi peritoneale, emodialisi, area critica, trapianti) ed in ognuna di esse vengono elencate le competenze di pertinenza infermieristica (sapere e saper fare, saper essere). L’elaborato si propone come strumento di riferimento, di confronto e di stimolo per le varie realtà operative nazionale dell’assistenza nefrologica.

Understanding the needs of who is in front of us, welcoming, accepting and guiding people that asks for help, being authentic, able to listen and understanding are all skills and abilities needed f...

Few studies have focused on the effect of music in patients undergoing haemodialysis.To determine the effects of live saxophone music on various physiological parameters and pain, mood and itching levels.A randomised controlled study with 114 patients undergoing haemodialysis with a control group (n = 57) and an experimental group (n = 57) who received 30 minutes of live saxophone music therapy.Systolic and diastolic blood pressure, pulse rate, glycaemia, oxygen saturation, pain, mood and itching levels were measured before and after the live music performance, resulting in baseline and post-test values for the patients in the experimental group.The experimental group showed a statistically significant reduction in pain level, and an improvement in mood and itching levels and in the oxygen saturation.Live saxophone music could be introduced to improve clinical and quality-of-life measures in patients undergoing haemodialysis.

Parallelamente al diversificarsi delle strategie di dialisi peritoneale, un grosso impulso ha avuto la ricerca di competenze assistenziali specifiche. Una ricerca nazionale EDTNA/ERCA (2005) ha permesso di conoscere le diverse realtà organizzative e assistenziali orientate alla continuità delle cure, oggi presupposto indispensabile per la costruzione della rete tra ospedale e territorio. Educazione terapeutica e competenze tecniche educative specifiche per gli adulti hanno caratterizzato la formazione che EDTNA/ERCA ha proposto, non supportando la tesi della marginalità della metodica e delle competenze professionali che la sua pratica richiede. Proprio quest'ultimo aspetto può essere una delle criticità per il suo sviluppo.

In parallel to the diversification of the strategies of peritoneal dialysis, a large impulse was given by the search for specific competences in the field of patients' care. A national research nam...