bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Renal Replacement Therapies
Authors: Gaspar Luis Jorge Rodrigues , Moreira Nelson Martins , Moutinho Aires Ademar , Pinto Paulo Jorge Moreira , Lima Helder Brízida 
Published: July 2012

SummaryContinuous Renal Replacement Therapy (CRRT) is frequently used in patients admitted to intensive care units with multiple organ failure and acute renal failure. These patients are prone to developing hypotension making it very difficult to use conventional haemodialysis for their treatment. When compared to conventional haemodialysis CRRT has obvious clinical advantages. These advantages are mostly due to slow volume and uraemic toxin removal leading to better haemodynamic tolerability for such patients.In our unit during the year 2000, 58 patients were submitted to CRRT: 14 of the patients underwent treatment with continuous veno‐venous haemofiltration and 44 were submitted to continuous veno‐venous haemodiafiltration. The mean patient age was 61.7 years (range: 20–87), 36 male and 22 females. Twenty patients (43.1%) had sepsis, 18 (31%) were post open‐heart surgery, 7 (12%) had multiple organ failure, 4 (6.9%) were polytraumatised, 3 (5.2%) were post neurosurgery and 1 (1.8%) was a liver transplant patient.Despite the grave prognosis of these patients, 22 (37.8%) survived and 36 (62.2%) died. Of the patients that survived, 10 (17.2%) recovered renal function and 12 (20.6%) remained on a regular haemodialysis programme. The authors conclude that CRRT seems to be an alternative to conventional haemodialysis for the treatment of those patients with acute renal failure.
Vascular access in Acute Renal Failure
Authors: Van Waeleghem J.P. 
Published: July 2012

SummaryToday, central venous access catheters play an important role in the treatment and management of many dialysis patients. Their use and care may influence the patient's overall outcome. Therefore, it is critical to have a thorough knowledge of the vascular anatomy, types of catheters, placement techniques and maintenance and management of complications.The incidence nowadays of acute renal failure in intensive care patients is reported as high as 25%. Acute renal failure is one of the few causes of organ failure in which complete recovery is possible, provided the patient survives the associated comorbid conditions. There are various extracorporeal dialysis techniques available to treat this category of patients using mostly a central dialysis catheter as vascular access.It is important to select carefully the type of catheter and to create a specific vascular access system in order to be able to perform the selected dialysis technique in the most optimal efficient conditions. Any inadequacies of access will create dialysis insufficiency leading to more comorbid conditions and even higher mortality.In this article, we will describe the different possibilities as well as the nursing management of that type of vascular access in patients with acute renal failure.
Who should manage continuous renal replacement in the intensive care setting? A nursing viewpoint
Authors: Martin R. K. 
Published: July 2012

SummarySince its inception, continuous renal replacement therapy (CRRT) has been performed in critical care units with or without the involvement of nephrology nursing support (1,2). It is apparent that the issue of providing care to patients requiring this therapy is not so much a debate on the nursing control of CRRT, but a focused discussion on the nursing management and delivery of care to the patient receiving CRRT in the intensive care setting.Although the choice of a nursing care model for CRRT is dependent on many clinical and organisational factors, the use of one nursing specialty to deliver CRRT care can leave gaps in practice. The Joint or Collaborative Nephrology/critical care nursing model brings the highest level of nursing expertise to the bedside. The joint model tends to promote collaboration between two distinct nursing specialties, with opportunities for setting joint standards and promoting research.With this in mind, this discussion will examine some of the factors affecting structuring of nursing care, describe nursing models currently in use, compare the attributes of each, and conclude which model is preferred for the delivery of nursing care for CRRT.
VASCULAR ACCESS QUALITY MONITORING
Authors: Lopot F. , Portová M. , Bednářová L. , Pilbauerová K. , Wittgrúberová M. , Nejedlý B. 
Published: July 2012

SUMMARYAccess dysfunction presents a risk for haemodialysis patients and is costly for health care providers. Regular vascular access quality (VAQ) monitoring enables the detection of adverse access conditions early allowing timely interventions, which will presumably be less invasive, more successful and cheaper. This paper reviews all currently used assessment parameters: dynamic and static pressures, recirculation and blood flow through the access — and analyses pros and cons of each of them. Based on this overview it is concluded that access flow monitoring should be the method of choice, possibly combined with monitoring of another parameter to further enlarge diagnostic possibilities of the monitoring. The VAQ monitoring system developed and used currently in the author's dialysis centre is briefly described as an example. The issue of access flow related to haemodynamics is briefly mentioned. With the introduction of any VAQ monitoring system, one has to acknowledge a change in structure of interventions and that the demand for surgical procedures decreases with a concurrent increase in percutaneous interventions.
PSYCHOLOGICAL CARE OF THE HAEMODIALYSIS PATIENT
Authors: Bath J. , Tonks S. , Edwards P. 
Published: July 2012

SUMMARYThe psychological care of patients at the haemodialysis unit is becoming an increasingly important aspect of the overall treatment of patients with end‐stage renal failure. As more is understood and reported regarding the impact of psychological factors on physical processes it becomes crucial that good quality psychological care is delivered to patients by nurses working at the haemodialysis unit. This study aimed to look at haemodialysis patients' perceptions of their treatment to discover if a dialysis centre in Southern England might benefit from a more formal system of psychological care.The data revealed four main themes that were of particular importance to the participants of this study: The New Self, Coping, Medical Concerns and Psychological Care. Within these areas of importance, the need for good quality information, the need for a suitable dialysis environment and the importance of social and family support were evident. Although the psychological care system that was in place at the unit appeared to be working well a more formal system of care might improve the patient experience.
NURSING TERMINALLY SICK DIALYSIS PATIENTS
Authors: De Miguel Bienvenido 
Published: July 2012

SUMMARYThe number of terminally sick patients (TSP) in haemodialysis (HD) is rising. The personnel that assist these patients wonder if they are sufficiently qualified to help and care for them and if TSP require treatment that is different to the other chronic dialysis patients. The reason for this study was to investigate if caring for TSP psychologically affected the infirmary personnel who looked after them during HD.
BED‐SIDE BLIND INSERTION OF PERITONEAL DIALYSIS CATHETERS
Authors: Dequidt C. , Vijt D. , Veys N. , Van Biesne W. 
Published: July 2012

SUMMARYAccess to the peritoneal cavity is an essential factor for successful peritoneal dialysis. The technique of catheter insertion can influence technique success and patient satisfaction. As compared to conventional surgical laparotomy, a bedside blind insertion technique under local anaesthesia has logistical advantages for the patient, the hospital and the community. This study compares outcomes of both methods in a single centre.A retrograde analysis of a prospectively collected database on all catheters implanted at the University hospital Ghent between 1/1/1998 and. 31/5/2002 was carried out. During this period, catheters were implanted either by conventional laparotomy (CL) or by a bedside blind insertion technique (BI) under local anaesthesia.
EVIDENCED BASED NEPHROLOGY CARE
Authors: Sedgewick JM. 
Published: July 2012

SUMMARYThis paper highlights the importance of evidenced‐based practice (EBP) and its implications to patient and health professionals working within nephrology. The need to ensure that practice is based upon best evidence should be a concern for all health care professionals. Confusion sometimes surrounds the concept of EBP and the potential impact this may have upon patient outcomes. It is the intention of this paper to firstly demystify the process of EBP highlighting the important factors to be considered in moving towards EBP in nephrology care. Secondly, the paper draws upon a number of well‐conducted research studies, which have important implications for nephrology care. These selected examples of best evidence will highlight further where ongoing work could be focused. Whilst there is much published within current literature concerning research within nephrology it is essential that practitioners are encouraged to develop the skills to critically search literature, appraise and evaluate its usefulness in developing appropriate and meaningful evidence to enhance practice and patient care.
THE EUROPEAN BASIC CORE CURRICULUM FOR NEPHROLOGY NURSING THE PROCESS OF WRITING, PUBLISHING AND DISSEMINATING
Authors: Fuchs S. , Thomas N. 
Published: July 2012

SUMMARYIn August 2002 the European Basic Core Curriculum (BCC) for Nephrology Nursing was published on the EDTNA/ERCA homepage. At the EDTNA/ERCA annual conference in The Hague in September 2002, it was presented to the delegates as an oral presentation and a poster presentation. Publicity flyers were translated into seven languages and distributed to delegates. This paper will describe the aims of the BCC, the process of writing and publishing, the use of the BCC in nursing schools and the measures that have already been taken in implementation and dissemination.
ACCREDITATION OF POST‐BASIC NEPHROLOGY COURSES WITHIN THE EDTNA/ERCA
Authors: Hurst J. , Thomas N. , Sedgewick J. , Reichardt M. 
Published: July 2012

SUMMARYThis paper will outline the development of the EDTNA/ERCA accreditation programme for post‐basic courses in nephrology. It will discuss results of the pilot project and relate the experiences of one school that has successfully gone through the accreditation process. The article will conclude with a discussion on more recent developments and evaluate the project in light of the original concepts.
A NURSE LED CENTRAL LINE INSERTION SERVICE
Authors: Casey J. , Davies J. 
Published: July 2012

SUMMARYAdvanced Nurse Practitioners (ANP) are developing their role in order to insert temporary and permanent central venous catheters to facilitate haemodialysis.Two hundred and eighty‐nine central venous catheters (CVC) were inserted over a two‐year period. The ANP inserted 117 CVC with 172 CVC inserted by the nephrology medical team. Using non‐parametric independent two—group comparison Mann Whitney test and Chi‐Squared test, the two groups were compared for specific outcomes. When comparing both groups with respect to CVC longevity, elective and non‐elective removal along with infection (exit site and systemic) no statistical difference between the ANP and the nephrology medical staff could be found.
THE HURDLES OF MIGRANT NURSES
Authors: Funtera C. Campos 
Published: July 2012

SUMMARYThe vast disequilibrium between healthcare providers and the recipients of care creates a hazard effect to all. This is a global issue as who will look after the growing and ageing population? Some countries have decided to recruit from outside their own country.Prior to registration, the Board of Nursing has imposed a regulation that a foreign nurse has to undergo a three‐ to six‐month adaptation programme. The main objective is to assess and evaluate and at the end of the programme it is hoped that the nurse will be deemed competent and safe to practice.Foreign nurses face tremendous challenges but are able to integrate with the provision of support services and an adaptation programme. This programme needs to be culturally sensitive to nurses who are used to work in a different system of health care.
ON‐LINE TECHNIQUE FOR PRODUCING SUBSTITUTION FLUID IN HAEMODIAFILTRATION AND HAEMOFILTRATION
Authors: Nystrand R. 
Published: July 2012

SUMMARYWhen the kidneys are not able to fulfil their task anymore the individual reaches a situation known as End‐Stage Renal Disease (ESRD). Haemodialysis may be carried out. In order to have a more efficient dialysis the treatment modes haemodiafiltration and haemofiltration are also in use. In these modes a substitution fluid is added to the bloodstream and continuously removed by the dialyser. However, these modes require large volumes of sterile fluids, 10 to 30 litres for haemodiafiltration and 70 − 100 litres for haemofiltration. This fact has made these treatment modes expensive.The fluids have traditionally been produced by the pharmaceutical industry in five litre bags, but in bags not all solutions are stable or possible to produce, for instance when sodium bicarbonate is used as a buffer. Today sodium bicarbonate is the absolute predominant buffer. An alternative way of producing the fluids has to be found. In 1978 LW Henderson (1) described a technique using filtration to produce substitution fluid on‐line i.e. preparing the fluid directly on site and giving it to the patient. Since then work has taken place in order to construct a system that is able to both mix, sterilise and administrate the substitution fluid in haemodiafiltration and haemofiltration. This work has resulted in dialysis machines with the feature to fulfil the task of producing sterile substitution fluid. On‐line haemodiafiltration is carried out in dialysis clinics. There are approximately 65 in Sweden, 1000 in Germany, 900 in Italy, 600 in France and 2500 in the US. The number of dialysis patients is around 1.000.000 worldwide and the increase is around 7 − 9% annually.
HOW TO EVALUATE ORGAN DONATION: THE QUALITY PROGRAMME IN TUSCANY
Authors: Matesanz R. , Bozzi G. , Saviozzi A.R. , Ferrini P.L. Rossi , Cardone A. ,   Tuscany Nurse Transplant Co‐ordinators
Published: July 2012

SUMMARYThe shortage of cadaveric organ donors imposes a severe limit on the number of patients who can benefit from transplantation. This paper describes a programme for evaluation and improvement of the organ donation process, which has been implemented in the hospitals of the Tuscany region, Italy. After analysing the first results it was found that there was great potential for growth, especially in those hospitals with neurosurgery where the weakest points of the process were detectedThe development of a quality improvement programme in cadaveric organ donation is an adequate and scientific method to detect where the problems in the process of organ donation lie. Ideally, the comparison of these data with those of other Italian or European regions should be very useful to plan adequate strategies to improve cadaveric organ donation.
POST INSERTION CATHETER CARE IN PERITONEAL DIALYSIS CENTRES ACROSS EUROPE: RESULTS OF THE POST INSERTION PROJECT OF THE RESEARCH BOARD
Authors: Castro M.J. , Vijt D. , Endall G. , Elseviers M. , Lindley E. ,   EDTNA/ERCA Research Board
Published: July 2012

SUMMARYThe EDTNA/ERCA survey of Post Insertion Catheter Care in Peritoneal Dialysis (PICC) was a project organised through the Collaborative Research Programme (CRP) of the EDTNA/ERCA. In this survey, data were collected from 54 participating centres in 20 countries.From this survey it became clear that there is no standardised approach to immediate post‐catheter insertion treatment protocols. If we want to reduce technique failure of PD related to catheter failure, a first step will be to investigate the different policies used in Europe in order to evaluate the outcome results derived from different policies in post insertion catheter care.
EUROPEAN PRACTICE DATABASE: COMPARATIVE RESULTS OF THE YEAR 1 PILOT PROJECT
Authors:   EDTNA/ERCA Research Board., Elseviers Monique , De Vos Jean‐Yves , Pancírová Jitka , Zampieron Alessandra , Lindley Elizabeth , Green Diane , Maurice Harrington National EPD Co‐ordinators  
Published: July 2012

SUMMARYThe European Practice Database (EPD) project, developed by the Research Board (RB) of EDTNA/ERCA, intended to collect data on renal practice at centre level in different European countries. During the pilot phase of the project (2002–2003), Czech Republic, Italy (North East) and England (North) participated with two thirds of all their eligible dialysis centres. Comparative results presented in this paper focus on centre size and patient characteristics, peritoneal and haemodialysis techniques, transplantation, infection control and the employment of technicians, dietitians and social workers in dialysis centres. At centre level, EPD results will enable in‐depth evaluation of personal practice. International comparison of the results will stimulate further research and the development of new guidelines.
EUROPEAN STUDY ON EPIDEMIOLOGY AND THE MANAGEMENT OF HCV IN THE HAEMODIALYSIS POPULATION. PART 1: CENTRE POLICY
Authors: Zampieron Alessandra , Jayasekera Heather , Elseviers Monique , Lindley Elizabeth , DeVos Jean‐Yves , Visser Ronald , Harrington Maurice 
Published: July 2012

SUMMARYHaemodialysis patients are known to be at risk of infection of Hepatitis C Virus (HCV) through nosocomial spread. This paper presents the first part of a study on epidemiology and management of HCV, in a haemodialysis population, conducted by the EDTNA/ERCA Research Board. Data on HCV management and infection control procedures was collected from 136 European centres using an electronic questionnaire. The study identifies a number of possible risk factors for transmission of the virus: failing to disinfect devices between patients, sharing of single‐use vials to prepare drugs or infusions for different patients, inadequate sterilisation or cleaning of machines between dialysis sessions, unsatisfactory environmental cleaning and distance less than one metre between chairs.
POST INSERTION CATHETER CARE IN PERITONEAL DIALYSIS (PD) CENTRES ACROSS EUROPE. PART 2: COMPLICATION RATES AND INDIVIDUAL PATIENT OUTCOMES
Authors:   EDTNA/ERCA Research Board, Vijt Denise , Castro Maria José , Endall Gerry , Lindley Elizabeth , Elseviers Monique 
Published: July 2012

SUMMARYThe first part of this report, which looked at centre policy, showed that there was no consensus on the best way to manage a patient in the rest period between PD catheter insertion and the first use of the catheter for dialysis. This paper intends to investigate if the differences in policy had any effect on complication rate and individual patient outcomes.Data were included from 298 patients of 49 participating centres. The results revealed a high rate of catheter related complications, with half of the patients having been treated for complications including leakage (29%), malfunction (23%) or infection (10%), and a quarter of patients having been hospitalised for catheter problems. Leakage was more frequently observed in lean and obese patients and if the catheter was only immobilized for a short time period. Diabetes, having constipation at first use and having rested for less than 6 hours after catheter insertion were significant risk factors for malfunction. Infection seemed to be related to the type of catheter used and hygienic precautions (not significant) and showed a significant relationship with the frequency of dressing changes. There is still an important lack of evidence on which to develop an optimal protocol for PD catheter insertion and care before first use.
EDTNA/ERCA VASCULAR ACCESS RECOMMENDATIONS FOR NEPHROLOGY NURSES
Authors:   Research Board of EDTNA/ERCA, Van Waeleghem Jean‐Pierre , Elseviers Monique , De Vos Jean‐Yves 
Published: July 2012

SUMMARYIn 1989, SJ. Schwab stated that providing satisfactory vascular access for haemodialysis remains one of the most challenging problems confronting the nephrology team (1). Successful long‐term haemodialysis in patients with end‐stage renal failure depends to a large extent upon a trouble‐free vascular access. Unfortunately, the creation as well as the use, maintenance and the treatment of vascular access complications nowadays still remain a serious clinical problem despite pharmacological and technical advances during the last decade (2). Even today, vascular access failure and complications form a major cause of morbidity leading to a high percentage (20 to 30 %) of hospitalization in the dialysis population (3).Moreover, we are confronted all over the world with a clinically complicated patient population, such as diabetics, patients with advanced atherosclerosis, cardiac and peripheral vascular diseases. Also the increased blood viscosity due to the systematic use of erythropoietin and the use of high blood flows in modern dialysis therapy necessitates a vascular access of excellent quality.
AN INTEGRATED VASCULAR MANAGEMENT PROGRAMME
Authors: Shemesh David , Olsha Oded , Berelowitz Daniel , Zigelman Charles 
Published: July 2012

SUMMARYThis paper discusses the development of an integrated approach for the creation and maintenance of arteriovenous access (AVA), under the direction of a dedicated vascular access surgeon in close cooperation with the haemodialysis staff, involving pre‐operative imaging, anaesthetic and surgical techniques together with a post‐operative graft surveillance programme, in order to maximize autogenous arteriovenous access (AAVA) construction (the preferred access for haemodialysis patients with end‐stage renal disease), and to improve patency rates for AAVA and prosthetic arteriovenous access (PAVA).
A DESCRIPTIVE ANALYSIS OF SLEEP DISTURBANCES IN PATIENTS WITH END‐STAGE RENAL DISEASE UNDERGOING HAEMODIALYSIS
Authors: De Barbieri Ilaria , Zampieron Alessandra 
Published: July 2012

SUMMARYMany studies reveal the presence of sleep disturbances in patients with end‐stage renal disease (ESRD) undergoing haemodialysis. The objective of this study was to identify the incidence of sleep disturbances in a sample of 112 patients, being treated by a dialysis centre. Patients who fulfilled the inclusion criteria, were interviewed by means of a questionnaire. The average age was 63.97, 79 male (70.5%) and 33 female (29.4%). The principal pathology underlying subjects' ESRD was hypertension (27.6%) and cardiovascular pathologies were the accompanying pathologies most suffered (75.8%).Sleep disturbances were noted in 54 patients (48.2%). These findings confirm the results of the literature, but less daytime sleepiness and nighttime waking occurred with this study group.
NURSING CARE FOR DIALYSIS PATIENTS IN JAPAN
Authors: Nakahara N. , Morita N. , Uchida M. , Kishimoto T. , Miura K. 
Published: July 2012

SUMMARYIn Japan, the number of chronic renal failure patients requiring dialysis treatment is increasing by approximately 10,000 patients a year, totalling 229,538 or 1,801.2 patients per one million population at the end of December, 2002 according to the survey conducted by the Japanese Society for Dialysis Therapy (1). The primary disease is diabetic nephropathy (28.1% of patients), and with greater numbers of long‐term and elderly patients, the incidence and severity of complications continue to increase. Dialysis units provide more diversified care, but budget cuts in health care make it difficult to secure sufficient personnel, and the workload on nurses has intensified. In this study, a survey of 157 out of 300 randomly selected dialysis facilities in Japan was made regarding nursing systems and nurses' concerns for medical care of dialysis patients.