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Coaching can enhance individual performance and promote a culture of collaboration and quality in the clinical setting. By utilizing the tools and skills inherent to coaching, individual and team outcomes can be elevated. In this article, an experienced nephrology nurse, who is also a certified coach, describes how the use of a coaching approach in professional development can lead to positive impact on workplace culture, and describes how nephrology nurses and leaders are in a key position to utilize aspects of coaching to enhance team cohesiveness, collaboration, and ultimately, patient outcomes. [ABSTRACT FROM AUTHOR]

Background: A key skill of nephrology nursing is cannulation of patients receiving haemodialysis. Traumatic and unsuccessful cannulation experiences, particularly in the initial weeks of haemodialysis, may contribute to the onset of needle distress for patients. Objectives: To identify the key knowledge, skills and attitudes of nephrology nurses working with haemodialysis patients and the competencies relevant to nephrology nursing working with patients with needle‐related distress. Design: A qualitative study involving semistructured interviews. Interviews were audio‐recorded, transcribed and deductive, and inductive thematic analysis applied. Participants: Nephrology nurses (n = 17) were interviewed from a tertiary kidney service in South Australia. Nurses had varying roles and years of experience (range 1–30 years) working with dialysis patients within the service. Results: Two overarching themes, (1) Flexibility in Practice and Care and (2) Responsibility of Nephrology Nursing, were identified as relevant across all knowledge, skills and attitudes of nephrology nurses working with patients with needle‐related distress. Thirty‐six knowledge, skills and attitudes were identified; 12 related to knowledge, 14 related to skills and 10 were identified as attitudes and were summarised under seven broad competencies. Conclusion: This study identifies potential knowledge, skills and attitudes and competencies required for nephrology nurses working with patients with needle‐related distress. It highlights strategies that may prevent the onset and worsening of needle‐related distress, as well as reduce it. It also brings to light that nurses desire additional education regarding strategies to improve the patient experience of cannulation and nurse confidence and skill in this area. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Yumei Liao,1,* Aihong Wang,1,* Wenjuan Sui,2 Abbas Khan,3 Zibo Xiong,1,4,5 Guang Yang1,4,5 1Division of Renal Medicine, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, 518036, People’s Republic of China; 2Institute of City Strategy Studies, Guangdong University of Foreign Studies, Guangzhou, Guangdong, 510006, People’s Republic of China; 3Department of Nutrition and Health Promotion, University of Home Economics Lahore Pakistan, Lahore, 54000, Pakistan; 4Institute of Nephrology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, 518036, People’s Republic of China; 5Shenzhen Clinical Research Centre for Urology and Nephrology, Shenzhen, Guangdong, 518036, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zibo Xiong; Guang Yang, Email xiong0301@163.com; guang.yang@pkuszh.comBackground: Nephrology nursing faces an inevitable challenge when it comes to falls. This study aims to review existing literature on falls in chronic kidney disease (CKD) patients and to discuss potential solutions.Methods: This review explores the characteristics and causes of falls in CKD patients, elucidate the underlying mechanisms, shares better nursing practices, and discusses both current prevention strategies as well as potential future interventions.Results: CKD patients often experience consciousness impairment and motor dysfunction due to factors such as muscle atrophy, nerve damage, malnutrition, anemia, fluid-electrolyte imbalances, hormonal disorders, and dialysis. Additionally, this study not only shares insights from nursing experience with these patients, but also reviews current evidence-based fall prevention strategies and proposes potential new interventions that could be tested in future research.Conclusion: CKD may increase the risk of involuntary falls in patients due to consciousness impairment and motor dysfunction. Advocating for a standardized expert consensus on fall risk assessment and comprehensive care for CKD patients would enhance the nursing framework in nephrology wards and help patients decrease their fall risk and elevate their quality of life.Keywords: falls, chronic kidney diseases, dialysis, nephrology nursing, anemia

This article examines the critical role of nursing leadership in the transition of nephrology care toward value-based models, highlighting how interdisciplinary care teams and population health management strategies are instrumental in improving patient outcomes and achieving health equity in kidney care. By reviewing both historical and present value-based care models in nephrology, this article showcases the evolution of care delivery and the strategic alignment of health care practices with value-based objectives. We introduce "HEALTH" as an innovative blueprint for nephrology nursing leadership, encapsulating key strategies to enhance kidney health care within the framework of value-based models. The acronym HEALTH stands for Holistic Care Integration, Equity and Tailored Care, Analytics and Machine Learning, Leverage Federal Programs, Training and Education, and Habit of Improvement, each representing a cornerstone in the strategic approach to advancing nephrology care. Through this lens, we discuss the impact of nursing leadership in fostering a culture of continuous improvement, leveraging technological advancements, and advocating for comprehensive and equitable patient care. This article aims to provide a roadmap for nursing leaders in nephrology to navigate the complexities of health care delivery, ensuring high-quality, cost-effective care that addresses the needs of a diverse patient population. [ABSTRACT FROM AUTHOR]

Introduction: Falls are a public health problem that weakens the patient and the health system. The primary objective was to describe the rate of falls in individuals admitted to a Nephrology Hospitalization Unit at a tertiary hospital in the Community of Madrid (Spain). At the same time, the secondary objectives were to describe the circumstances surrounding them and the risk factors presented by the subjects. Material and method: Cross-sectional descriptive study of falls occurring in individuals admitted to a Nephrology Hospitalization Unit at a tertiary hospital in Madrid from January 2012 to December 2021. Results: 80 people suffered a fall (n=80). The fall rate in nephrology per 1000 days of stay was 1.45, while the overall fall rate in the hospital, including the nephrology unit, was 1.22, both showing an upward trend. 68.8% (55) were men, with a mean age of 72.58 ± 14.06 years. The majority were partially dependent, 43.8% (35), 76.3% (61) were polymedicated and presented a high risk of falling, 53.8% (43). 22.5% (18) presented visual deficit, 17.5% (14) hearing deficit, and the majority had balance disorders 56.3% (45) and/or muscle weakness 72.5% (58); 35% (28) suffered urinary incontinence and 31.3% (25) fecal incontinence. Most of the falls occurred in the room 66.3% (53), due to sliding 41.3% (33). Most people, 73.8% (59), did not suffer consequences. Discussion and Conclusions: The fall rate has been increasing over the ten years described in this study, both in the Nephrology Hospitalization Unit and the whole institution. Subjects with CKD have an increased risk of presenting multiple risk factors, which is consistent with the results of this investigation. Identifying individuals at risk of falls becomes particularly important in this population and should be one of the top priorities for healthcare professionals, especially nursing staff who provide care. [ABSTRACT FROM AUTHOR]

Increasing global migration necessitates a larger, more diverse, and more culturally responsive nursing workforce. If health care organizations are to foster a culture of inclusion, they must employ strategies to retain the current nursing workforce and prepare for greater diversity in the future. Nurses are leaving the profession for many reasons. Nurses report too much stress and overwork, along with not feeling valued in their roles. Nursing leadership must work to address retention of the current workforce and implement additional strategies to support long-term pipelines for more diverse nurses. Interactive workshops and mentoring focused on foundational definitions and concepts are strategies to increase retention and preparation for future recruitment. This article discusses strategies to foster a greater sense of belonging in the workplace for all nurses. This article also discusses strategies that can be useful in retaining a nursing workforce and preparing for the future nursing workforce by fostering a culture of responsiveness that encourages a sense of belonging for all nurses. [ABSTRACT FROM AUTHOR]

This year (2023) marks the 50th year of the publication of the official journal of the American Nephrology Nurses Association (ANNA). To recognize this event, we conducted an archival review of the journal dating back to the first issue. The review provided a glimpse into the care of patients with kidney disease and the history of nephrology nursing. This article focuses on the early years of the journal. [ABSTRACT FROM AUTHOR]

With an increased emphasis on home dialysis therapies (HDTs), and to ensure nephrology nurses have a voice in health policy discussions and decisions, the American Nephrology Nurses Association (ANNA) initiated the Home Dialysis Therapies Task Force. ANNA fully supports the increased utilization of HDTs and wants to ensure every individual has the option of HDT and deserves an RN in their care. Careful consideration must be given to the impact of legislative initiatives aimed at the nursing shortage and increasing the use of HDTs on delivery of safe care and RN practice. The HDT Task Force implemented a Think Tank to explore and delineate the role of nephrology RNs in HDT to ensure a safe and informed transition to HDT for individuals with kidney failure. The mission was to gather and analyze information on the role of the nephrology RN in HDTs, clarify RN-specific tasks versus tasks that may be delegated to support staff, and gather and gain insight into barriers to HDTs. [ABSTRACT FROM AUTHOR]

Analyze patient safety in hemodialysis clinics in Northeastern Brazil. Methods: One hundred eighty-one nursing professionals from 11 hemodialysis clinics in Fortaleza, Brazil, participated. Data collection occurred through the application of a sociodemographic characterization form and the Patient Safety Assessment Scale for Chronic Patients in Hemodialysis. Descriptive analysis of quantitative variables and the Chi-Square and Likelihood Ratio statistical tests were performed. Results: The study showed that 165 (91.2%) subjects received safe care practices, while 16 (8.8%) received unsafe care practices, originating from two (18%) hemodialysis clinics. There was a significant association between work hours (p = 0.017) and participation in patient safety training (p = 0.005) and care practices. Conclusion: Non-compliant patient safety practices were identified, associated with sociodemographic factors of the nursing team. Targeted interventions are needed to improve patient safety in these settings. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the use of a renal health application by kidney transplant recipients. Method: a retrospective, observational study with a sample composed of individuals registered in the kidney transplant section of the application from July of 2018 to April of 2021. Demographic data, data entry, time of use, weight, blood pressure, blood glucose, creatinine, medication schedules, appointments, and tests were the variables collected. Descriptive analysis of the data was performed. Results: eight hundred and twenty-three downloads of the application were identified, and 12.3% of those were registered as kidney transplant recipients, the majority from southeastern Brazil (44.9%), 36±11 years old, and female (59.1%). Of the sample, 35.1% entered information such as creatinine (62%), weight (58.2%), and blood pressure (51.8%). Most used the application for one day (63.3%) and 13.9% for more than one hundred days. Those who used it for more than one day (36.7%) recorded weight (69%), medication intake (65.5%) and creatinine (62%), and scheduled appointments (69%). Conclusion: the kidney transplant recipient section of the Renal Health application generated interest in the young population, but showed low adherence throughout the assessed months. These results offer a relevant perspective on the implementation of mHealth technologies in kidney transplantation. [ABSTRACT FROM AUTHOR]

Aimed to evaluate the mental health of people living with chronic kidney disease on hemodialysis. This is a cross-sectional study with 11 patients from a hemodialysis clinic in the city of Teresópolis-RJ. The positive mental health questionnaire was used as a data collection instrument. Participants reached a total score of (119.16) on the proposed instrument, performing positive mental health. In the factors personal satisfaction the score (25.27), pro-social attitude (15.27), selfcontrol (14.0), autonomy (16.36), problem solving/personal satisfaction (27.18) and relationship skills interpersonal (21.64). On the other hand, the participants in their answers tended to think that life is monotonous, they feel dissatisfied with themselves, with their physical appearance. It was possible to identify positive mental health in the quantitative perspective. However, there is an emotional ambivalence. Thus, it is necessary to subjectively explore the ambivalence of the answers. Such reflections help to understand the biopsychosocial dimensions to guarantee comprehensive nursing care. [ABSTRACT FROM AUTHOR]

Abstract Objective: to evaluate the use of a renal health application by kidney transplant recipients. Method: a retrospective, observational study with a sample composed of individuals registered in the kidney transplant section of the application from July of 2018 to April of 2021. Demographic data, data entry, time of use, weight, blood pressure, blood glucose, creatinine, medication schedules, appointments, and tests were the variables collected. Descriptive analysis of the data was performed. Results: eight hundred and twenty-three downloads of the application were identified, and 12.3% of those were registered as kidney transplant recipients, the majority from southeastern Brazil (44.9%), 36±11 years old, and female (59.1%). Of the sample, 35.1% entered information such as creatinine (62%), weight (58.2%), and blood pressure (51.8%). Most used the application for one day (63.3%) and 13.9% for more than one hundred days. Those who used it for more than one day (36.7%) recorded weight (69%), medication intake (65.5%) and creatinine (62%), and scheduled appointments (69%). Conclusion: the kidney transplant recipient section of the Renal Health application generated interest in the young population, but showed low adherence throughout the assessed months. These results offer a relevant perspective on the implementation of mHealth technologies in kidney transplantation.

Background: Peritoneal dialysis (PD) is a major renal replacement therapy modality for patients with end-stage kidney disease (ESKD) worldwide. As poor self-care of PD patients could lead to serious complications, including peritonitis, exit-site infection, technique failure, and death; several nurse-based educational interventions have been introduced. However, these interventions varied and have been supported by small-scale studies so the effectiveness of nurse-based educational interventions on clinical outcomes of PD patients has been inconclusive. Objectives: To evaluate the effectiveness of nurse-based education interventions in PD patients. Design: A systematic review and meta-analysis of Randomized Controlled Trials (RCTs). Methods: We performed a systematic search using PubMed, Embase, and CENTRAL up to December 31, 2021. Selection criteria included Randomized Controlled Trials (RCTs) relevant to nurse-based education interventions in ESKD patients with PD in the English language. The meta-analyses were conducted using a random-effects model to evaluate the summary outcomes of peritonitis, PD-related infection, mortality, transfer to hemodialysis, and quality of life (QoL). Results: From 9,816 potential studies, 71 theme-related abstracts were selected for further full-text articles screening against eligibility criteria. As a result, eleven studies (1,506 PD patients in seven countries) were included in our systematic review. Of eleven studies, eight studies (1,363 PD patients in five countries) were included in the meta-analysis. Sleep QoL in the intervention group was statistically significantly higher than control (mean difference = 12.76, 95% confidence intervals 5.26–20.27). There was no difference between intervention and control groups on peritonitis, PD-related infection, HD transfer, and overall QoL. Conclusions: Nurse-based educational interventions could help reduce some PD complications, of which only the sleep QoL showed statistically significant improvement. High-quality evidence on the nurse-based educational interventions was limited and more RCTs are needed to provide more robust outcomes. Tweetable abstract: Nurse-based educational interventions showed promising sleep quality improvement and potential peritonitis risk reduction among PD patients.

Transplant is the preferred treatment option for patients with end stage kidney disease. Patients with kidney disease should be informed about the transplant option, and if appropriate, referred for a transplant evaluation. Early referral is key to getting patients transplanted quicker because the evaluation is extensive and the waiting time on the deceased donor kidney transplant list is years. Understanding the steps in a transplant evaluation process can help providers and staff educate and support their patients through the evaluation process., Competing Interests: The author reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

Nurse well-being is critical for safe and efficient health care delivery, particularly in complex and demanding specialties like nephrology. However, levels of burnout are rising and may relate to a largely unexplored phenomenon: loneliness. This study investigated the phenomenon of nurse loneliness as a potential factor in burnout. A mixed-methods approach was used to investigate burnout and loneliness in a national sample of nephrology nurses. Together with workforce demographics, burnout and loneliness were measured, prevalence was estimated, and correlations were examined. Interpretive descriptive inquiry and analysis was used to develop a richer understanding of nurse loneliness in the context of burnout. In the study population (n = 217), rates of burnout were low, but positively correlated with loneliness. Qualitative interviews reveal that organizational and systemic pressures, recognition and peer support, work environment and demands, and physical and emotional well-being are components of the experience of current nephrology nurses related to loneliness and burnout., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

More and more nursing homes are admitting residents receiving dialysis. In 2023, the Centers for Medicare and Medicare Services released guidance addressing the qualifications of those caring for these residents and further clarified the survey process. The American Nephrology Nurses Association Board of Directors created the Home Dialysis for Nursing Home Residents Task Force to review the revised guidance, investigate strategies and opportunities for nephrology registered nurses in home dialysis therapy in this setting, and consider the potential implications related to alternative home dialysis settings. This article discusses their process, findings, and outcomes., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

Value-based care (VBC) aims to improve patient health outcomes relative to the cost of care by shifting from traditional fee-for-service models to patient-centered, outcome-driven approaches. This framework is particularly important in nephrology, where high costs associated with chronic kidney disease (CKD) and end stage kidney disease have prompted the adoption of new care models. Key programs such as the Comprehensive End-Stage Renal Disease Care Model and the Kidney Care Choices program have introduced multidisciplinary teams and early-stage CKD interventions to improve patient outcomes and reduce costs. This article highlights the essential role of interdisciplinary collaboration in VBC, with registered nurses, nurse practitioners, pharmacists, social workers, dietitians, and physicians coordinating care to address clinical and non-clinical needs. Case studies demonstrate the effectiveness of coordinated efforts in medication management, patient education, and addressing social determinants of health. These examples underscore the potential for VBC to significantly improve patient outcomes in kidney care while addressing health care inequities and reducing overall costs. Findings emphasize the importance of early interventions, interdisciplinary teamwork, and targeted support for patients with CKD in achieving VBC outcomes., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

Introduction: Dialysis nurses play a paramount role in vascular access (VA) management. The aim of this study is to evaluate dialysis nurses' knowledge, attitude, practice and self-efficacy (KACP-SE) pertaining to VA cannulation and evaluation., Method: An anonymous self-administered survey was administered to dialysis nurses from two tertiary hospitals (four dialysis units) and two community dialysis centres from April to May 2022. The 37-items survey consists of four dimensions of questions relating to VA cannulation and management: knowledge, attitude, practice and self-efficacy. The content validity and face validity of the survey was reviewed by three experienced VA professionals and five dialysis nurses respectively. The internal consistency and construct validity of the survey have been assessed with psychometric tests., Results: There were 23 and 47 nurses, working in the participated community and tertiary hospital dialysis centres respectively, responded to the survey. The internal consistency coefficients indicated acceptable reliability of the instrument (KR-20 coefficient was 0.55 and 0.76 for knowledge and practice domains; Cronbach's α was 0.85 and 0.64 for self-efficacy and attitude domains). In the exploratory factor analysis for attitude and self-efficacy, the instrument could account for 64.0% and 53.0% of the total variance respectively. In the knowledge domain, five out of eight single-select multiple-choice questions were correctly answered by >70% of the participants. Overall, the mean (±SD) of participants' total self-efficacy score was 24.3 (±3.1) over total score of 30. The majority of the participants (82.4%) either agreed or strongly agreed that ultrasound guidance is useful for cannulation., Conclusion: This KAP-SE instrument can be used to evaluate knowledge, attitude, practice and self-efficacy of dialysis nurses toward VA management. The participants demonstrated acceptable knowledge level, but with some knowledge gaps identified. It also revealed nurses' good self-efficacy level and welcoming attitude towards adopting ultrasound in VA cannulation among the participants., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Nephrology Nursing Scope and Standards of Practice, 9th Edition, published by the American Nephrology Nurses Association, defines the scope of nephrology nursing and provides standards of practice, standards of professional performance, and competencies for registered nurses and graduate-level prepared registered nurses (e.g., advanced practice registered nurses, clinical nurse specialists) in an approach consistent with the American Nurses Association's Nursing Scope and Standards of Practice, published in 2021. Discussions addressing respect, equity, inclusion, and social justice have been included in the 9th edition. A new section related to altered/crisis standards has been added to assist nephrology nurses in developing strategies for implementing those standards. The section on how to use the standards has been updated with forms that organizations can download and individualize. This article provides an overview of the scope, standards, competencies, and strategies for implementing them in clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: For Nephrology nurses, the fear and anxiety of impending death of a patient with End Stage Kidney Disease is very real. The literature highlights the near invisibility of impending death and the anxiety experienced by Nephrology nurses who care for patients with End Stage Kidney Disease. Following the deaths of their patients, nephrology nurses may suffer from a personal loss because of the prolonged countertransference in the relationship between them and their patients and often the family and other caregivers. Aim of the study: The study explores and describes Nephrology Nurses’ experiences of caring for dying patients with End Stage Kidney Disease following withdrawal of dialysis. Methodology: A qualitative research design using a phenomenological approach was found to be appropriate for this study. Data was collected through phenomenological conversations and analysed using Colaizzi’s seven step inductive method.A purposive heterogeneous sampling method was used to select eight Nephrology nurses who met the inclusion criteria in the research setting at two private renal dialysis centres in Cape Town, South Africa.The phenomenological conversations were guided by a leading question and a set list of conversational prompts. The phenomenological conversations were digitally recorded and transcribed verbatim. Results: After the feedback sessions, four main themes emerged: emotional trauma, detachment, loss of altruistic values in nursing, and being-with-death. Conclusion: Irrespective of the participants extensive involvement in treating patients with End Stage Kidney Disease, there was immense emotional trauma with no support from hospital management. It was evident from an ontological perspective that the participants realised the reality of their own death. It is recommended that the educational aspects of death and dying are incorporated in curricula. This study endorses the need for further research into patients with End Stage Kidney Disease and how to better care for them at end-of-life.

Background: End-stage renal disease (ESRD) is the final stage of chronic kidney disease. Yet dialysis is not suitable for all ESRD patients. Moreover, while shared decision-making (SDM) is the preferred model for making medical decisions, little is known about SDM between nephrology nurses and ESRD patients in Israel., Research Objective: Assessing the views, attitudes, practices, and ethical dilemmas of nephrology nurses in Israel regarding SDM with ESRD patients., Methods: Using the descriptive quantitative approach, questionnaires were completed by 444 nephrology nurses in Israel. In addition to conducting descriptive statistics, t-tests for independent samples, f-tests for analysis of variance, and both tests for independence were also performed., Ethical Considerations: The research aims, expected advantages and risks have been explained to respondents before completing the questionnaire to secure informed consent. Anonymity and confidentiality were ensured throughout the study. The study was approved by the Research Ethics Committee at the University of Haifa (Approval # 411/21)., Results: About one-third (30%-36.5%) of nurses reported discussing quality of life issues with ESRD patients, asking about their advance directives/power of attorney, exploring cultural/religious beliefs in end-of-life care, and ask about their preferred place of death. Nurses who convey high levels of patient-centered care (68.9%, p <0.0001), have high end-of-life training (76.2%, p <0.0001), and report cooperating with interdisciplinary teams (63.8%, p = 0.0415), also reported higher SDM practices than others. Nurses who refer less patients to palliative care (70%, p <0.0001) reported higher involvement in SDM compared to other nurses., Conclusions: Nephrology nurses in Israel do not tend to implement the SDM model, despite its potential for improving quality of life for ESRD patients and their families and increasing conservative care options. Policy makers and educators in Israel should develop and implement training programs and support in the workplace, to enhance SDM between nephrology nurses and ESRD patients., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article provides an update on patient safety data recently reviewed by and recommendations of the President's Council of Advisors on Science and Tech - nology. This article attempts to capture the impact of the eroding ability of the nursing workforce to perform its traditional role of blocking errors before they harm patients. Some strategies, tactics, and practice examples to assist in renewing this protective capacity in today's challenging environment are presented. Finally, acknowledging the variability of substantive support for maintaining a safety culture provided by individual health care organizations, this article encourages and applauds the personal courage of nephrology nurses and other health care providers as they engage and assist their clinical and quality improvement teams in addressing the persistence of what Hughes (2008) termed the "everydayness of errors" (p. 1-7)., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

The American Nephrology Nurses Association (ANNA) and American Society of Nephrology (ASN) have joined forces with the goal of advancing improvements in kidney care through transformative change. Through the integration of expertise, resources, and networks from both organizations, these collaborations have the potential to improve patient outcomes, advance clinical practice, and shape policy initiatives. In this article, we describe our focus on three areas: strengthening the nephrology and nephrology nursing workforce, championing health care equity, and advocating for kidney health., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objectivesThe Centers for Medicare & Medicaid Services (CMS) requires that dialysis centers inform new patients of their transplant options and document compliance using the CMS-2728 Medical Evidence Form (Form-2728). This study compared reports of transplant education for new dialysis patients reported to CMS with descriptions from transplant educators (predominantly dialysis nurses and social workers) of their centers' quantity of and specific educational practices. The goal was to determine what specific transplant education occurred and whether provision of transplant education was associated with center-level variation in transplant wait-listing rates.Design, setting, participants, & measurementsForm-2728 data were drawn for 1558 incident dialysis patients at 170 centers in the Heartland Kidney Network (Iowa, Kansas, Missouri, and Nebraska) in 2009-2011; educators at these centers completed a survey describing their transplant educational practices. Educators' own survey responses were compared with Form-2728 reports for patients at each corresponding center. The association of quantity of transplant education practices used with wait-listing rates across dialysis centers was examined using multivariable negative binomial regression.ResultsAccording to Form-2728, 77% of patients (n=1203) were informed of their transplant options within 45 days. Educators, who reported low levels of transplant knowledge themselves (six of 12 questions answered correctly), most commonly reported giving oral recommendations to begin transplant evaluation (988 informed patients educated, 81% of centers) and referrals to external transplant education programs (959 informed patients educated, 81% of centers). Only 18% reported having detailed discussions about transplant with their patients. Compared with others, centers that used more than three educational activities (incident rate ratio, 1.36; 95% confidence interval, 1.07 to 1.73) had higher transplant wait-listing rates.ConclusionsWhile most educators inform new patients that transplant is an option, dialysis centers with higher wait-listing rates use multiple transplant education strategies.

ABSTRACT Objective: To measure the average direct cost of procedures performed by health professionals, in a Dialysis Center, for the management of complications of vascular access for hemodialysis. Method: Quantitative, exploratory-descriptive case study type research. The average direct cost was calculated by multiplying the time spent by health professionals by the unit cost of direct labor, adding this to the input costs (materials/ medicines/solutions). Results: The following average direct costs were obtained: US$0.72, US$2.00 and US$1.41 for “administration of easy-to-dilute, difficult-to-dilute, and undiluted antibiotics”, respectively; $2.61 for “central venous catheter dressing with topical antibiotic”; $48.05 for “alteplase infusion”; US$183.68 for “insertion of central venous catheter for hemodialysis”; and $1.31 for “arteriovenous fistula puncture”. Conclusion: Material and drug costs significantly contributed to the composition of the average total direct cost of most procedures.

ABSTRACT Objective: To evaluate the effect of prayer on religious/spiritual coping and on the hope of patients with chronic kidney disease undergoing hemodialysis. Method: Randomized, controlled and blinded clinical trial, carried out in a dialysis unit, with a total of 62 patients undergoing hemodialysis – 31 participants in intervention group and 31 in the control group. Intercession prayer was applied three times, in alternate weeks, during hemodialysis sessions. Differences between groups in the outcome of the effect of prayer on religious/spiritual coping and hope were analyzed. Results: Participants used positive coping at high mean scores in both groups (control – 3.62 and intervention – 3.26) and negative coping had little use (control – 1.66 and intervention – 1.47). The use of total coping was between 2.35 and 2.48 in the intervention group (p = 0.015). Hope variables were better in the intervention group: optimism (p = 0.001), short- and long-term plans (p = 0.004), remembering happy moments (p = 0.039) and valuing life (p = 0.050). Conclusion: The use of prayer promotes an increase in religious/spiritual coping and hope. Brazilian Registry of Clinical Trials: RBR-4pphkf.

Abstract Objective: to evaluate the complications of percutaneous renal biopsy based on outcomes and clinical indicators of the Nursing Outcomes Classification. Method: a prospective longitudinal study. The sample consisted of 13 patients submitted to percutaneous renal biopsy, with 65 evaluations. The patients were evaluated in five moments in the 24 hours after the procedure, using an instrument developed by the researchers based on five outcomes (Blood coagulation, Circulation status, Blood loss severity, Pain level, Comfort status: Physical) and 11 indicators. The Generalized Estimation Equation Test was used to compare the scores of the indicators. The project was approved by the institutional ethics committee. Results: in the 65 evaluations, a statistically significant difference was identified in the reduction of the scores of the following nursing outcomes: Blood coagulation, “hematuria” indicator; Circulation status, in the “systolic blood pressure and diastolic blood pressure” indicators and Comfort status: physical, in the “physical well-being” indicator. Conclusion: the evaluated patients did not show major complications. The clinical indicators signaled changes in circulation status, with reduced blood pressure, as well as in blood clotting observed by hematuria, but without hemodynamic instability. The comfort status was affected by the rest time after the procedure.

Abstract Aim To explore patients’ and healthcare professionals’ experiences and perspectives on collaboration in the kidney transplantation process. Design A qualitative study with a phenomenological‐hermeneutic approach. Method Participant observation and interviews were conducted with 18 patients, together with a focus group with eight healthcare professionals from April 2016–January 2017. The data analysis was inspired by Ricoeur's theory. Results While patients acknowledged that the healthcare professionals were experts, they also requested an everyday life approach to treatment and care, because both professional knowledge and everyday life experiences were needed to manage everyday life. A contrast between patients’ experiences and healthcare professionals’ knowledge was identified, and the empowerment approach could be a way to combine the different perspectives.

ABSTRACT Objectives: to identify feelings, experiences, and expectations of kidney transplant patients, generated from the diagnosis of chronic renal disease until the post-transplant period, highlighting the challenges for nurses to incorporate individualized care to cope throughout the disease process. Methods: qualitative, descriptive research, carried with seven kidney transplant patients, in the city of Manaus, State of Amazonas. The data analysis followed the methodological referential of Bardin’s content analysis. Results: the diagnosis of the disease was experienced negatively, and hemodialysis was described as an imprisonment and health decline. The transplant meant an improvement in quality of life. The main difficulties were lack of a specialized hospital and low immunity. Conclusions: the nurses’ approach of chronic renal patient and with the renal transplantation favored the discovery of solutions facing the demands of the disease and allowed greater capacity to implement individualized care, surrounding a relationship of trust and respect.

Pediatric primary nephrotic syndrome in children represents a group of glomerular diseases characterized by edema, proteinuria, hypoalbuminemia, and dyslipidemia. The disease process is often complex and labile, entangled with frequent hospitalizations and clinical complications. Its clinical complications are extensive and require careful evaluation and monitoring. Frequent complications include thromboembolism, infections, hypertension, acute kidney injury (AKI), and posterior reversible encephalopathy syndrome (PRES). Various pharmacologic agents are used to treat children with this group of glomerular diseases, aiming to preserve kidney function and prevent chronic kidney disease. Pediatric primary nephrotic syndrome is a life-altering diagnosis that is linked with poorer health-related quality of life and implicated in negative impacts on social and emotional functioning for those affected by the disease. Pediatric nurses play a key role in addressing physiologic presentations and complications of the disease, including edema and hypertension; moreover, pediatric nurses should aid in providing appropriate educational support to patients who are afflicted by such convoluted disease processes and their families. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: To know the nurse's routine in the hemodialysis sector of a public hospital in Northeast Brazil. Methods: Field study of exploratory and descriptive nature, qualitative approach. Developed in the hemodialysis sector of a public hospital located in Campina Grande, Paraíba, with all nurses working in the sector. Data collection took place in September 2017, through semi-structured interviews, and analyzed following the theory proposed by Bardin. Results: Nurses were interviewed with an average age of 41 years, predominantly female and with an average time of eight years working in the hemodialysis sector. The following categories emerged from the content analysis: Nursing assignments in the hemodialysis sector; Nursing management in the hemodialysis service; Systematization of nursing care in the hemodialysis service; Adversities and complications found in the hemodialysis sector; and Actions by the nursing team to minimize risks and possible complications. Conclusão: The multiplicity of duties and activities in the routine of nurses in the hemodialysis sector was evident in our study, which showed the essential role and role of nurses within such a specific and highly complex sector. [ABSTRACT FROM AUTHOR]

Objective: To analyze the relationship between functional health literacy and decreased renal function capacity of people with diabetes mellitus treated at a referral health unit in the state of Pernambuco. Methods: A descriptive cross-sectional study with a quantitative approach, the sample was made up of 70 participants, who underwent an assessment of the level of functional health literacy, using the Brief Test of Functional Health Literacy in Adults (B-TOFHLA) questionnaire, and measurement of the estimated glomerular filtration rate. Chi-square statistical tests with Pearson's correlation, Student's T and Mann-Whitney were used. Results: The main results were the statistical association between inadequate health functional literacy, estimated glomerular filtration rate and reduced serum creatinine. Conclusion: This study showed a statistical association between functional health literacy with essential variables in the control and prevention of chronic kidney disease in people with diabetes mellitus, these data can support the nurse in the search for strategies to promote patients to perform self-management in health of to minimize the complications of this pathology. [ABSTRACT FROM AUTHOR]

Aims: To (a) assess patients' interest and perceived capability of participating in haemodialysis; (b) assess nurses' perceptions of patients' interest and perceived capability of participating in haemodialysis; and (c) examine associations between patient characteristics and interest and perceived capability of performing haemodialysis self‐care. Design: Cross‐sectional, questionnaire‐based study. Methods: Data were collected from dialysis patients and their nurses between October 2018–May 2019. Patients' interest and perceived capability of participation were assessed by a 10‐item Likert‐type scale developed and tested for this study, with responses ranging from 1 (not interested/no perceived capability) to 5 (already doing task independently). Multivariate linear regression was used to assess the relationship between patient characteristics, including age, sex, education level and severity of illness to ratings of activation level and haemodialysis self‐care scale scores. The STROBE checklist was used as a guideline for this study. Results: Ninety‐one patients and 31 nurses participated. Overall, patients expressed interest (2.43 ± 0.93) and perceived themselves capable (2.34 ± 0.9) of participating in various haemodialysis‐related tasks. Nurses assessed lower interest (2.19 ± 0.77) than patients, but similar average capability (2.31 ± 0.8). Both greater interest and perceived capability were correlated with more years of education and higher patient activation; additionally, interest was associated with disease severity and perceived capability was associated with age. Conclusion: Haemodialysis patients are interested and perceive themselves capable of participating in the tasks involved in dialysis care. Nurses underestimate patient interest in participation. Relevance to clinical practice: Self‐care behaviours among haemodialysis patients are important, as they may affect quality of life and survival. Determining interest and perceived capability of participation is a first step towards evaluating the feasibility of self‐care in a supervised haemodialysis setting. [ABSTRACT FROM AUTHOR]

An important factor for quality and safety in patient care is an environment in which quality and safety are prioritized and embedded into the culture. Quality improvement (QI) methods can be complex, with some intensive resources required and specific methods employed. However, all staff can be involved in QI if the problem is approached with curiosity and the process is kept simple, with a consistent goal of improving practices. The purpose of this article is to highlight some simple but effective QI methods authored by all-star nephrology nurses that can be easily applied by teams in various settings with minimal resources. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the complications of percutaneous renal biopsy based on outcomes and clinical indicators of the Nursing Outcomes Classification. Method: a prospective longitudinal study. The sample consisted of 13 patients submitted to percutaneous renal biopsy, with 65 evaluations. The patients were evaluated in five moments in the 24 hours after the procedure, using an instrument developed by the researchers based on five outcomes (Blood coagulation, Circulation status, Blood loss severity, Pain level, Comfort status: Physical) and 11 indicators. The Generalized Estimation Equation Test was used to compare the scores of the indicators. The project was approved by the institutional ethics committee. Results: in the 65 evaluations, a statistically significant difference was identified in the reduction of the scores of the following nursing outcomes: Blood coagulation, "hematuria" indicator; Circulation status, in the "systolic blood pressure and diastolic blood pressure" indicators and Comfort status: physical, in the "physical well-being" indicator. Conclusion: the evaluated patients did not show major complications. The clinical indicators signaled changes in circulation status, with reduced blood pressure, as well as in blood clotting observed by hematuria, but without hemodynamic instability. The comfort status was affected by the rest time after the procedure. [ABSTRACT FROM AUTHOR]

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To better understand the current status of nephrology nursing in the United States, nephrology nurse leaders from the American Nephrology Nurses Association and the leading nephrology care provider organizations were asked their perceptions of pressing issues facing nephrology nurses. Each described their experiences and how they are handling the challenges and opportunities in their respective organizations., Competing Interests: The author reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

Nurse leaders play a critical part in supporting the safety of patients and their staff. Their guidance in establishing a robust safety culture and engagement in preparing their organizations for the survey is important in eliminating patient harm. Ensuring the dialysis facility and staff are survey-ready promotes a culture dedicated to patient wellbeing and safety. This article describes the survey process in dialysis facilities and provides survey tips to guide nurse managers in being survey-ready every day., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)