bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPLICATIONS OF VASCULAR ACCESS: RESULTS OF A EUROPEAN MULTI CENTRE STUDY OF THE EDTNA/ERCA RESEARCH BOARD
Authors: Elseviers Monique M. , Van Waeleghem Jean‐Pierre 
Published: July 2012

SUMMARYThe pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. In the second part of the study, individual patients were followed prospectively during one year. This paper reports on several topics of the second part of the project, investigating complications of the VA related to centre, patient characteristics and dialysis techniques. used.Complications most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Gradually more infections and flow problems were observed if the centre size and the patients/nurse ratio went up.Complication rate was not significantly influenced by age, gender, renal diagnosis, time on dialysis or medication used by the patient. In contrast, the number of vascular accesses in the past and interventions in the VA before first use resulted in an increased number of complications.Nurses have a key role in the prevention, manipulation and outcome of vascular access related complications.
DISCOVERING THE CULTURE OF HAEMODIALYSIS UNITS: AN ETHNOGRAPHY
Authors: Aswanden C. 
Published: July 2012

SUMMARYThere is an increasing renal population but a lack of resources available to ensure that every renal patient receives the maximum benefit from Renal Replacement Therapy (RRT). The aim of this paper is to illustrate how understanding the culture of dialysis units will facilitate the provision of more therapeutic, patient centred care. This paper describes briefly the research study that was undertaken to uncover the culture which is in dialysis units but as yet undiscovered and therefore not valued. Once this culture is better understood and valued both patients and the health care teams will be facilitated to work towards the common goal of better treatment outcomes.
BURNOUT IN RENAL CARE PROFESSIONALS
Authors: Kotzabassaki S. , Parissopoulos S. 
Published: July 2012

SUMMARYBurnout is defined as “a syndrome of emotional exhaustion, depersonalisation and reduced personal accomplishment that can occur among individuals who work with people in some capacity”, and it can be considered as a result of long‐term exposure to occupational stress (1,2). Frequently reported occupational stressors among caring professionals are those intrinsic to the job, related to patient demands, related to roles within the organisation, and those related to relationships at work and career development. In renal care however, there are some unique characteristics such as technologically advanced equipment, the intensive caring environment and the long‐term relationships being established between the carer and chronic renal patients, that one should take into consideration. It seems that job resources may act as moderators to burnout. Furthermore, specific personality characteristics and socio‐demographic variables seem to affect the burnout experience. Individual and social organisational means for burnout prevention and coping are discussed and suggested.
COUNSELLING SHOULD BE OFFERED TO PEOPLE WITH END‐STAGE RENAL FAILURE
Authors: Kelly M. , Tibbles R. 
Published: July 2012

SUMMARYHaving a counsellor as a member of the multiprofessional team has made a positive contribution to the way in which people with end‐stage renal failure manage their illness. This paper will show how families can be supported when someone close to them develops renal failure. A self‐report questionnaire was sent to those who used the renal counselling service over a one‐year period. Findings suggest that those who received a period of short‐term counselling were able to cope more effectively with their illness and lifestyle changes and felt less stress as a result. The limitations of the evaluation will be discussed, however, we are not seeking to generalise our results but to describe our experience in our unit. This points to the value and necessity of having someone with the requisite skills, to offer people a place to talk about often difficult and painful emotions. In our professional opinion, all renal units should consider having a counsellor as part of an integrated approach to patient care.
RENAL ANAEMIA — THE PATIENT EXPERIENCE
Authors: Mahon A. , Docherty B. 
Published: July 2012

SUMMARYIn progress within the United Kingdom (UK) is the provision of a National Service Framework (NSF) for Renal Services. The Renal NSF aims to raise standards, provide equity of care, reduce variations in services and improve the health care of renal patients (1). The Renal NSF will be published in four distinct modules, each relating to a major area of renal care: effective delivery of dialysis, transplantation, prevention and primary care and alternative models of care. Taking into account the opinions of patients based on national surveys, has been recognised as an essential component in the modernisation programme of the NHS (2), and therefore this national survey represents consultation on current service provision. In 2000, the UK's National Kidney Federation (NKF) (supported by an educational grant from Amgen Ltd) conducted a postal survey of UK patients with renal diseases. This paper provides the patient perspective on anaemia management from this survey together with the implications for clinical practice for nurses and renal healthcare teams.
EUROPEAN PRACTICE DATABASE IN THE CZECH REPUBLIC
Authors: Pancírová Jitka , Kraciková Jindra , Lopot František , De Vos Jean‐Yves , Elseviers Monique 
Published: July 2012

SUMMARYThe EDTNA/ERCA European Practice Database (EPD) Project has been launched with the aim to collect data on professional practice and outcome of dialysis treatment throughout Europe. The Czech Republic had the privilege of taking part in the pilot phase together with Northern England and part of Italy. We first became involved in the EPD project during the annual EDTNA/ERCA conference in Nice, France. At this time the Research Board started to prepare an EPD questionnaire for the pilot phase. The project was officially launched in the Czech Republic during the Multidisciplinary Conference in Brno organised jointly by the Czech Association of Nurses and the EDTNA/ERCA in 2003. A presentation by Jean Yves De Vos, the EPD Co‐ordinator, who introduced the final EPD questionnaire in detail, was the best promotion of the project.
CHOICE OF RENAL REPLACEMENT THERAPY IN PATIENTS WITH DIABETIC END STAGE RENAL DISEASE
Authors: Giri M. 
Published: July 2012

SUMMARYDiabetic nephropathy is becoming the leading cause of end‐stage renal disease (ESRD) worldwide. Although the prognosis of patients with diabetes and ESRD receiving Renal Replacement Therapy (RRT) has improved greatly, the presence of pre‐existing cardiovascular disease means that the survival and medical rehabilitation of diabetics continue to be inferior to that of non‐diabetics. RRT should be initiated earlier in patients with diabetes than in non‐diabetics and the main choices of modalities are: 1) haemodialysis (HD), 2) Peritoneal dialysis (PD), 3) Kidney transplantation alone (KTA) or 4) simultaneous kidney and pancreas transplantation (SPKT). The most common modality of RRT utilised in the diabetic patient remains HD but this method is associated with many clinical problems, in particular the managment of vascular access and frequent intradialytic hypotension. There is accumulating evidence demonstrating that both survival and medcal rehabilitation of patients with diabetes and ESRD is superior after renal transplantation with or without pancreas transplantation.
NUTRITIONAL COUNSELLING FOR DIABETIC RENAL PATIENTS
Authors: Hoogerwerf M. 
Published: July 2012

SUMMARYA diabetic patient who develops nephropathy has to cope with two different diets. Healthy food guidelines have to be followed and attention paid to the spread of carbohydrates throughout the day because of the diabetes. Renal failure means that attention also has to be paid to protein, sodium, potassium and fluid intake and the diet can be confusing to patients. When dialysis commences the management of, and attention to the diabetes is sometimes a little forgotten. This article identifies problems and how they may be dealt with.
PATIENT AND PROFESSIONAL PARTNERSHIP IN DIABETIC NEPHROPATHY
Authors: Cox SA. , Keogh AM. 
Published: July 2012

SUMMARYDiabetes mellitus (DM) is a complex multifaceted metabolic disorder characterised by chronic disease processes of hyperglycaemia and changes in the metabolism of carbohydrates, fats and proteins (1, 2). It holds no boundaries with age, gender, culture or social strata (3). It is a life long disease process, which belongs to the individual (4), impacting on physical, social, psychosocial and spiritual life experiences (5).Diabetes is a worldwide burden to healthcare providers. In the United Kingdom (UK) 1.4 million people are affected with a suspected million people undiagnosed (6). A significant subgroup of patients with DM are predisposed to developing diabetic nephropathy, and it is now the single commonest cause of end‐stage renal failure, accounting for 16% of new patients taken on to renal replacement therapy each year (7). It is in this subgroup that other diabetes related complications such as retinopathy, neuropathy and peripheral vascular disease are also concentrated (8). Microalbuminuria is an early indicator of renal disease in diabetes, and also predictive of total mortality, cardiovascular mortality and cardiovascular morbidity (9). These associated macro and microvascular complications can result in high personal, social and financial costs of managing complications associated with diabetic nephropathy and end‐stage renal disease (ESRD). Some ethnic groups are particularly vulnerable ‐ in the UK, the incidence of ESRD in South Asians and African Caribbean's is three times higher than in White Caucasians, in part due to the high prevalence of diabetic nephropathy (10).
PAIN DEGREE AND SKIN DAMAGE DURING ARTERIO‐VENOUS FISTULA PUNCTURE
Authors: Montero Rodolfo Crespo , Arellano Flora Rivero , Abad María Dolores Contreres , Gómez Angela Martínez , Galán María Isabel Fuentes 
Published: July 2012

SUMMARYThe aims of this study were to evaluate the effect of needle bevel position on the degree of pain and damage to the skin covering the vein, in an arteriovenous fistula puncture, in haemodialysis patients.48 patients with autologous arteriovenous fistula were studied. After puncture the patient was asked about the degree of pain perceived by means of an analogue visual scale and a descriptive verbal scale. When the needle was removed, the length of the cut made by the puncture was measured.The perceived pain assessed by analogue visual scale was greatest when the needle was punctured with the bevel facing upwards rather than downwards (median: 3 versus 2, p<0.003).The prick in the skin was greater when the puncture was made with the bevel facing upwards (19.7 ± 5.6) rather than downwards (16.2 ± 3.8, p < 0.0001).It is concluded that arteriovenous fistula puncture with the bevel facing downward significantly reduces the degree of pain and the skin lesion at the point of puncture, without increasing the number of punctures.
ESTABLISHING NEPHROLOGY NURSING SPECIALIZATION IN JAPAN: A MATTER OF URGENCY
Authors: Terada I. , Hyde C. 
Published: July 2012

SUMMARYThis paper explores the current situation regarding the provision of renal services to patients with end‐stage renal disease in Japan. The statistical data reveal that Japan is in a predicament regarding the current rate of incidence of end‐stage renal disease in the population. The discussion highlights the fact that nephrology nursing practice is as yet not recognised as a speciality in its own right in Japan. Therefore Japanese nurses who work in the field of nephrology are still struggling to establish their own professional identity and to improve the professional level of their practice. This situation persists in Japan despite support from the literature, which confirms that appropriately qualified nephrology nurses are well equipped to provide specialised care. The recent decision by the Japanese Association of Nephrology Nurses is to establish the position of the specialised dialysis nurse, which does not cover the area of kidney transplantation and will start in 2004. It is expected that it will be an important challenge to improve professional skills and nephrology nursing status in Japan.
SIMPLE PRESSURE MEASUREMENT IS NOT RELIABLE IN DETECTION OF ACCESS STENOSIS IN NATIVE AV FISTULAS
Authors: Portová M. , Hor̆ení J. , Kr̆emenová E. , Nejedlý B. , Válek M. , Lopot F. 
Published: July 2012

SUMMARYDynamic arterial and venous pressures (PA, PV) are used as the simplest tools to assess vascular access quality (VAQ). An increased PV over three consecutive dialyses is believed to indicate a stenosis, a rule devised for synthetic grafts (AVG) but not adequately validated for AV fistulas (AVF). In this study dynamic PV and static intra‐access pressure (calculated by means of the simplified formula PIA=(PA+PV)/2) changes were evaluated in 46 accesses in which balloon angioplasty had to eventually be performed.The whole group consisted of 30 forearm AVF, 5 upper arm AVF and 11 AVG. Pressures were compared in each patient at a time of satisfactory access flow (QVA) and immediately before the angioplasty and pressure difference over that period (ΔPV, ΔPIA) evaluated. Despite a significant drop in QVA over the follow‐up interval in both AVF and AVG, the mean ΔPV and ΔPIA in AVF were only several mm Hg and the chosen threshold limit of 20 mmHg was exceeded in approximately 10% of patients only.The results in the AVG group were, however, very different: The mean ΔPV and ΔPIA were close to 20 mmHg and almost 60% of patients in the AVG group exceeded this limit. Evaluation of PIA did not improve stenosis detection in either group. It is concluded that PV and/or PIA monitoring may be useful to detect a stenosis in AVG but not in AVF.
A HAEMODIALYSIS NUTRITIONAL SCREENING TOOL FOR NURSES ‐ A PILOT STUDY
Authors: Bennett P. , Breugelmans L. , Meade A. , Parkhurst D. 
Published: July 2012

SUMMARYThe purpose of the study was to pilot a nurse‐performed nutritional screening tool (NST) for dialysis patients in order to identify nutritionally at‐risk patients.Haemodialysis (HD) patients are at risk of nutritional‐related problems. Nutritional screening by nurses may assist in the early recognition of and response to these problems.An NST was developed using 9 screening parameters. (BMI, weight change, poor appetite, GI symptoms, albumin, pre‐dialysis urea, K+, PO4++, HbA1c). The NST was compared with Standard Dietitian Assessment (SDA).44 HD patients were screened with the NST and then with SDA.The tool showed sensitivity of 0.7 (95%Cl+/‐0.21) and a specificity of 0.77 (95%Cl+/‐0.16).Reliability was low (alpha =.18). Alpha increased to 0.32 if pre‐dialysis urea was removed from the tool and increased to 0.48 if weight loss, appetite, K+ and PO4++ were used alone.The pilot study showed a low reliability of the NST compared with SDA. With further analysis and modifications, the NST has the potential to assist nutritional screening by nurses in dialysis centres that have limited dietetic access.
A REVIEW OF THE UPDATED EUROPEAN BEST PRACTICE GUIDELINES FOR THE MANAGEMENT OF ANAEMIA IN PATIENTS WITH CHRONIC RENAL FAILURE
Authors: Jenkins K. 
Published: July 2012

SUMMARYThe management of anaemia of Chronic Kidney Disease (CKD) has progressed significantly during the last decade. Research studies show that effective treatment of anaemia in adult patients with CKD can reduce cardiovascular complications (1,2) slow progression of renal failure (3), and improve quality of life (4). To ensure adult patients receive optimum care, evidence‐based practice and recognised guidelines and management strategies are needed to help reduce variations in clinical practice.In 1999 a working party of European Nephrologists developed the European Best Practice Guidelines (EBPG) for Management of Anaemia in Patients with Chronic Renal Failure to address this issue (5). Since the publication of the guidelines in 1999, over 3,000 papers relating to anaemia in CKD, have been published, many of which have significant implications for the practice of anaemia management. To ensure that the most up to date scientific evidence is available to those who manage anaemia in CKD the guidelines were revised in 2004 (6). These guidelines, look at the anaemia management of adults with CKD and do not include guidelines for children.
ULTRA VIOLET ABSORBANCE ON‐LINE MEASUREMENT UTILIZED TO MONITOR CLINICAL EVENTS DURING HAEMODIALYSIS
Authors: Uhlin F. , Fridolin I. , Magnusson M. , Lindberg L.‐G. 
Published: July 2012

AbstractBackground — On‐line monitoring systems of spent dialysate, used to estimate dialysis dose, have been developed with different instrumentation during the last two decades. The routine use of an on‐line monitoring system has been suggested to provide an adequate dialysis dose to the haemodialysis (HD) patient. The aim of this study was to show that monitoring the spent dialysate using UV‐absorbance might bring new information about the clearance process.Methods — 108 HD treatments distributed among 16 clinical stable patients were monitored on‐line using ultra violet (UV) absorbance. For the measurement of UV‐absorbance a spectrophotometer was connected to the fluid outlet of the dialysis machine with all spent dialysate passing through a flow cuvette. The UV‐absorbance curves were examined in combination with the recorded observations of events that occurred during the studied treatments.Results — The study demonstrates that UV‐absorbance visualizes different kinds of events such as hypotension, conductivity alarms and restricted flow in artery needle blood pump stops that often occur during dialysis treatment.Conclusion — An on‐line UV‐monitoring system with a high sampling rate makes it possible to identify variations in dialysis clearance of different origin and gives feedback after performing interventions during a dialysis session.
THE TECHNOLOGY BEHIND THE IMPROVEMENT IN ANAEMIA MANAGEMENT
Authors: Johnson S. , Byrne P. 
Published: July 2012

SUMMARYThe Renal Anaemia Management (RAM) Programme is a unique service available in 18 major renal centres around Australia. Since its inception some 6 years ago, the software package has been modified to accommodate the needs of the renal team and the renal patient population. In addition, with the support of nephrologists, the RAM software has created a specialised role, that of the Renal Anaemia Coordinator (RAC).The RAM software collects clinical data and patient characteristics from patients with anaemia associated with renal disease. This is an integral part of a national exchange of information for the optimal management of the overall health of the renal patient population.The RAM database is a valuable tool that has changed the practice of anaemia management and improved the outcomes of patients with renal insufficiency. RAM provides a rapid method of reviewing haematological and biological parameters on a regular basis with a multidisciplinary approach. At a glance, RACs can now detect trends in determining vascular access programming, dietetic review, and patient education and support services. This has allowed the Renal Anaemia service to reach common goals and improve outcomes. The RAC provides a point of contact and education for patient, family members and their general practitioner's regarding erythropoietin therapy. This advancement in technology has revolutionised the collection of information about individual patients and their presenting history of renal failure. It has also allowed for earlier recognition and treatment of renal disease.
A CARE PATHWAY FOR THE END OF LIFE IN A RENAL SETTING
Authors: Hinton V. , Fish M. 
Published: July 2012

SUMMARYBackground — A care pathway for the end‐of‐life had been implemented onto the two renal wards. An audit was performed to highlight potential issues and areas for development.Method — The audit consisted of a base review of documentation from the medical notes of 10 patients who had died an ‘expected’ death prior to commencing the renal Integrated Care Pathway (ICP) for the end of life and then 10 patients who had died whilst using the ICP documentation. A questionnaire was also given out to nursing staff who had used the ICP documentation. The results were collated and analysed.Results — In the base review 100% of the documentation looked at did not provide a regular documented assessment of symptoms that are common in the terminal phase of life. The ICP provided a documented assessment of all of these main symptoms. The base review indicated a good response by doctors to meet the potential needs of the patient, but the ICP improved on this. This was through the use of a pre‐emptive prescription. 80% of all patients were pain free, not agitated, had no nausea or vomiting or respiratory secretions. The 2 patients that had pain received further analgesia and were then pain free at the next assessment. One of the most positive aspects of the audit was that 90% of relatives were aware that the patient was dying and 100% had the plan of care discussed with them.Conclusion — Implementing the ICP has generated the opportunity to deliver a hospice model of care to a busy renal unit. It has allowed best practice, and a measurable standard of care, in the final stages of patients' lives. Staff find the documentation easy to use and also see it as enhancing patient care.
TUBERCULOSIS IN HAEMODIALYSIS: A PROBLEM MAKING A COMEBACK
Authors: Zyga S. , Tourouki G. 
Published: July 2012

ABSTRACTTuberculosis (TB) accounts for a significant proportion of all deaths by infectious diseases. Controlling tuberculosis is a major public health issue especially in the developing nations, where the rise of the disease's incidence varies between 5–30% and the rise reaches reduplication every 5–10 years. The consequences of the disease in renal dialysis patients vary between 3.7–6%, thus being 12–15 times higher than the rest of the population.
BLOOD PRESSURE MEASUREMENT
Authors: Vilaplana J.MaG. 
Published: July 2012

SUMMARYBlood pressure measurement is the basis for the diagnosis, management, treatment, epidemiology and research of hypertension and the decisions affecting these aspects of hypertension will be influenced by the accuracy of measurement. Although blood pressure measurement is one of the most common clinical techniques, there are some factors affecting it, such as blood pressure variability or blood pressure measuring devices. Blood pressure can be measured in different ways:
Clinic blood pressure measurement is taken in physician's office. The accurate measurement of blood pressure in clinical practice is dependent on the individual, the equipment used and the observer; this is the most common when considering therapeutic decisions.
Self blood pressure measurement provides us with values on different days, in settings as close to daily life conditions as possible, having no white‐coat effect.
Ambulatory blood pressure measurement. With this method, using devices that permit the automatic monitoring of blood pressure in a patients normal life, health professionals are able to have blood pressure values over 24 hours, as well as the possibility of average blood pressure values over a requested period, such as the day or the night.
IMPROVING THE NUTRITIONAL CONDITION OF INFANTS AND YOUNG CHILDREN UNDERGOING HEMODIALYSIS
Authors: Zioni N. 
Published: July 2012

SUMMARYThe growing number of infants receiving HD treatment has led to an increased awareness among the nursing staff of the unique and complex needs of children undergoing chronic treatment. As part of the overall treatment, nurses must broaden their knowledge of medical advancements in numerous areas: Increased knowledge in the area of child growth and development and unique formulas and “supplements”.