bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do anaemia co‐ordinators have to be nurses?
Authors: Sanders D. , Hibbert D. , Ackrill P. , Clinkard S. , Cooke J. , Cottrell N. 
Published: July 2012

SummaryThe role of the anaemia co‐ordinator has developed subsequent to the introduction of erythropoietin therapy for renal anaemia, and posts have been established at an increasing number of hospitals in the UK. While co‐ordinators have previously tended to come from a nursing background, the post at our hospital has been held jointly by a pharmacist and a clinical nurse specialist since July 1997. This paper presents an informal evaluation of our experience of joint working, and has drawn on diary entries to outline the components of the service provided. The main focus is on the boundary negotiated between pharmacist and nurse responsibilities and expertise, involving as it does areas of potential conflict and complementarity. Through a critical examination of the assumptions and expectations associated with ‘generic’ pharmacist and nurse roles, we begin to clarify the respective contributions which the disciplines make to anaemia management.
Nursing implications of a Vancomycin resistant Enterococcus outbreak in a renal unit
Authors: Taylor J. , Stevenson G. 
Published: July 2012

SummaryVancomycin Resitant Enterococcusis a difficult organism to treat and is becoming more prevalent world‐wide. When it was identified in a busy renal unit, radical and expensive measures were taken to try and control the outbreak. Although these had costs to both patients and staff, the organism was eradicated from the unit.
Caring for renal patients during loss and bereavement
Authors: Binkley L. 
Published: July 2012

SummaryMany of us are not prepared in assisting patients through the final phase of the life cycle. Recognising physical manifestations of stress, understanding why patients experience loss with kidney disease, and realising the supportive role that staff play for a patient undergoing this process, are key to assisting the patient to cope with loss and bereavement. The renal caregiver can assist the patient to view the ESRD life from another perspective as they journey through the life cycle to death. In so doing, the renal caregiver can recognise the needs of the family during this period, thus making them feel they fulfil a valuable role in the patient's final care. Being with a patient and family at the time of death is extremely rewarding as it helps the staff bring closure to the nurse patient relationship.
Provision of counselling for the dying patient
Authors: Hine J. 
Published: July 2012

SummaryThe majority of doctors and nurses clearly recognise their responsibility to provide palliative care to the dying patient, and also the need for effective communication, counselling and support for this group of patients. This paper explores some of the issues preventing patient and significant others from being referred to the counselling service at this stage, and demonstrates that the nursing staff feel both inadequate and ill prepared to deliver quality care to the dying patient and use avoidance as a coping mechanism.
Self perception affecting adherence to drug regimen following renal transplantation
Authors: Trevitt R. , Whittaker C. , Ball E.A. 
Published: July 2012

SummaryThe patient, a chronic cannabis user, found it increasingly difficult to tolerate the side effects of the medication on her appearance. Rejection in the early post‐transplant period meant that immunosuppression could not be further reduced. We were able to avoid a catastrophic self‐initiated cut in immunosuppression, and withdrawal of steroids was carried out according to a schedule supervised by the clinic. Cellular rejection resulted and was treated with IV methyl prednisolone and conversion from cyclosporin micro‐emulsion (Neoral®, Novartis) to tacrolimus (Prograf®, Fujisawa) and from azathioprine to mycophenolate mofetil (CellCept®, Roche).
Adherence to treatment and personality in renal failure
Authors: Vives T. , Pujolar N. , Junyent E. , Flores I. , Cordovilla L. , Izquierdo R. 
Published: July 2012

SummaryAdherence of individual treatment and personality dimension of locus of control was analysed. Evidence suggests that locus of control and other personality dimensions can influence adherence behaviour to treatment. The aim of this study was to examine the impact of social‐clinical factors over personality dimensions and to provide empirical evidence of the relationship between internal locus of control experience and higher level of the compliance to treatment and diet. The results have shown the low level of adherence of patients to treatment and we found a tendency to correlate the dimension locus of internal control with adherence to treatment.
Assessment of problems: which study design?
Authors: Elseviers M. 
Published: July 2012

SummaryEvidence‐based medicine has gained recognition in recent years, necessitating a large amount of conclusive results derived from a large number of experimental and epidemiological studies. Renal nurses are preferable investigators in this field because of their close relationship with the renal patient. Apart from clinical studies, with an experimental study design varying a single factor between two groups of patients, epidemiological studies are needed to assess actual problems. Epidemiological studies are purely based on observation, without altering any factor. The choice of study design will depend on the available knowledge about the problem and available resources.
Stay•safe®. A new PVC free system in long‐term CAPD treatment
Authors: Lambert M.C. , Lage C. , Kirchgessner J. 
Published: July 2012

SummaryStay·safe® is a new PVC free double bag PD system that was introduced two years ago for CAPD. The system has been evaluated by three target groups, patients, nurses and physicians in 2 different studies. In the pilot study stay·safe® was compared to the previous system and in the multi centre study, new patients judged stay·safe® over a longer period of time. The pilot study showed better handling and function judgement by experienced patients of the new system compared to previous. In the multi centre study the overall satisfaction with the new system including use with disabled patients was very good and this high valuation was maintained over time.
Results of a national epidemiological investigation of HCV infection in dialysis patients
Authors:   Italian Branch of the EDTNA/ERCA, Lombardi M. , Cerrai T. , Geatti S. , Negroni S. , Pertusini L. , Pegoraro M. , Di Lullo G. 
Published: July 2012

SummaryThe Italian Branch of EDTNA/ERCA organised a national, epidemiological, retrospective study to collect data and implement preventative measures for the spread of HCV infection in dialysis units. A questionnaire was sent to staff in 830 dialysis centres to collect information relating to 1996. Data are presented on incidence/prevalence of HCV infection, antibodies, viraemia and mortality, and comparison of the management of HCV between centres. At variance with the recommendations of the Official Health Organisations, dedicated machines and separate rooms are used in many centres and this paper concludes with recommendations for units, in particular those units with a low prevalence of antiHCV positive patients.
Nephrology nursing practice: more than technical expertise
Authors: Ran K. Jung , Hyde C. 
Published: July 2012

SummaryThis paper argues that the role of the nephrology nurse goes far beyond the generally accepted parameters of technical expert to include the roles of care giver, advocate, educator, facilitator, mentor and referral agent. Patients with End Stage Renal Disease, who require long term dialysis, experience many stressors which they must cope with in order to achieve an acceptable quality of life. Nephrology nurses who understand the stress of living with dialysis, and who are familiar with the coping strategies a patient may use, are ideally placed to facilitate the process of adaptation from the patient and their families perspective.
Malaria. A challenge for the haemodialysis and intensive care nurse
Authors: Uys H. , Nel E. 
Published: July 2012

SummaryMalaria is the world's most important tropical parasitic disease. In many developing countries, and Africa in particular, malaria exacts an enormous toll in lives, medical costs, and days of lost labour. Through the use of case studies, this paper explores the effects of malaria and the patient management by the haemodialysis and intensive care nurse. All malaria cases admitted to an intensive care unit, and treated by means of haemodialysis or continuous‐veno‐veno‐haemodiafiltration were analysed. Specific problems identified were impaired fluid and biochemical control, acid‐base imbalance, disseminated intra vascular coagulation, adult respiratory distress syndrome, and haemodynamic instability. Guidelines were compiled for the nursing management of these complicated malaria cases.
Algorithmic nursing protocol to provide optimum care post combined kidney/pancreas transplantation
Authors: Henderson A. , Prendergast E. 
Published: July 2012

SummaryThis paper explains the development of protocols to aid in the care of patients following a combined kidney / pancreas transplant. With adequate planning of care, medical and nursing problems can be detected at an early stage thus ensuring immediate and appropriated action. We have found protocols to be invaluable in the care of these patients and the one which we developed on fluids and electrolytes is outlined in this paper.
Relation between response to illness and compliance in haemodialysis patients
Authors: Saounatsou M. 
Published: July 2012

SummaryThe treatment schedule of the haemodialysis patients has many restrictions and the long‐term haemodialysis patient's response to illness is characterised by various emotional reactions Compliance with their medical regimens remains a significant problem which influences the progress of health and by extension quality of life. The preconceived idea that a patient's response to illness may influence his adherence to medical regimen led to this study. The main variables examined were the relationship between the patient's response to illness and compliance and the relationship between compliance and age, education and the length of time on haemodialysis.
Stress, coping and quality of life among chronic haemodialysis patients
Authors: Cristóvão F. 
Published: July 2012

SummaryThis study identifies the most significant stressors perceived by individuals undergoing haemodialysis due to chronic renal failure, the coping methods used most often by patients, and their quality of life. 75 patients aged 18–65 years old, and on regular haemodialysis for at least for one year were studied. Results showed that patients perceived high levels of stress, and that psychosocial stressors are as problematic as the physiological ones. Patients used problem‐oriented coping methods more often than affective‐oriented methods. Although their quality of life was satisfactory, patients were dissatisfied about their physical well being.
Improving adequacy improves haemodialysis outcome
Authors: Charra B. 
Published: July 2012

SummaryOur goal of maintenance dialysis for the coming millennium is optimal rather than just adequate dialysis. Delivering a large amount of dialysis expressed in terms of urea Kt/V is a necessary but insufficient measure to improve clinical outcome. Cardiovascular morbidity and mortality remain very high in haemodialysis. This is due in great part to the insufficient control of extra cellular volume and blood pressure. Ours, as well as published data, indicate that up to now, only increasing dialysis time either by prolonging the session or increasing its frequency has proven value in overcoming this critical issue.
One haemodialysis unit's experience of hepatitis B
Authors: Balshaw A , Casey J 
Published: July 2012

SummaryHaemodialysis patients are at high risk of contracting Hepatitis B Virus (HBV). This blood borne virus has been responsible for many critical incidents within haemodialysis units around the world. This paper seeks to explore one such outbreak and at the same time look more closely at HBV and connected issues. The incident discussed occurred within a haemodialysis unit situated in the Northwest of England. This paper is presented as a case study. When HBV was detected in a previously HBV negative patient a crisis management team moved quickly to contain any possible outbreak and sought to discover the origin of the infection. An outline of the personal and financial cost to the organisation, what lessons have been learnt and why recommendations have been made to immunise the local dialysis population again HBV will be presented.
Heparinisation in chronic haemodialysis treatment: bolus injection or continuous homogenous infusion?
Authors: De Vos J.Y. , Marzoughi H. , Hombrouckx R. 
Published: July 2012

SummaryAfter several incidents where patients either bled after dialysis or suffered severe anaphylactic reactions caused by intravenous heparin injections, we decided to administer heparin as a continuous homogenous intravenous infusion. This had been usual practice in our unit in the past. Following the shocking experience of the death of a patient due to an anaphylactic reaction during his first dialysis, we wanted to warn colleagues for the potential dangers of administering intravenous heparin as a bolus injection.
Evaluation of potential transplant recipients and living donors
Authors: Trevitt R. , Whittaker C. , Ball E.A. 
Published: July 2012

SummaryThe transplant waiting list needs to be actively managed by the transplant centre in a systematic way to achieve any degree of efficiency and effectiveness. This paper describes the key role of the transplant nurse in a large centre with over 300 people on the transplant waiting list. It focuses on the way patients are assessed, how the list is updated and the benefit of nurse involvement in the work‐up of potential live donors.
Pathogenesis and treatment of diabetic nephropathy
Authors: Lameire Norbert 
Published: July 2012

SummaryDiabetic nephorpathy is a major cause of renal disease, but clinically evident diabetic nephropathy may be reduced by better glycaemic control. Patients with type 1 and type 2 diabetes should be screened yearly for microalbuminuria and treatment commenced with angiotensin converting enzyme inhibitors if indicated.
Dialysis visitation project: testing professional quality
Authors: Mutsaers R. 
Published: July 2012

SummaryIn many hospitals the professional aspects of the functioning of dialysis centres are tested by separate associations of professionals and the organizational aspects by associations of professionals or by government authorities, such as the ‘National Health Care Inspectorate’. In countries where the government's interference is declining, associations of professionals, patients and health care providers are stimulated to take responsibility for further improvement in quality of dialysis treatment. This article demonstrates how the quality of renal replacement therapy can be made clear, and most importantly testable.
Compliance of haemodialysis patients with prescribed medication
Authors: Gago C. , Gónzalez S. , Marco B. , Fernández J. , Jarriz A. , Martinez S. , Gónzalez A. , Gálvez C. , Andrea C. , Hernando P. , Hernández J. , Gruss E. 
Published: July 2012

summaryThis study was designed to monitor the compliance of haemodialysis patients with their prescribed medicines and to analyse factors associated with non‐compliance. We conducted a transversal and descriptive study of 121 haemodialysis patients. The patient compliance to prescribed medicines was evaluated according to the percentage of tablets prescribed and taken. Gender, duration of dialysis treatment, knowledge about prescribed medicines, and family status were not related to patient compliance. However the compliance of patients younger than 65 years was 90.4% vs. 84.6% in patients over 65 years (p < 0.06) and the compliance of patients with academic knowledge was 89.6% vs. 83.7% in patients without it (p < 0.06). The most frequent cause of non‐compliance was the wrong interpretation of treatment (33.9%).
Provision of dietary advice in selected centres across Europe
Authors:   For the EDTNA/ERCA Collaborative Research Programme, Nevett G , Nagel C , Elseviers MM , Lindley EJ 
Published: July 2012

summaryThe EDTNA/ERCA survey of the provision of dietary advice in renal care was the second project organised through the Collaborative Research Programme (CRP). Data was collected from 51 participating centres in 19 countries. Advice on nutrition was provided by a multidisciplinary team, normally led by a specialist renal dietitian or a medical doctor, in 90% of participating centres. There was a general consensus on the type of advice that should be provided, in that most patients routinely received advice on intake of protein, energy and minerals in over 70% of centres. There was also good agreement on daily protein requirements expressed as g/kg, but considerable variation in the calculation of the body weight that determines the dietary intake for an individual patient. This could lead to significant differences in the advice offered and suggests that guidelines on assessment and use of ideal body weight should be included in the new EDTNA/ERCA Nutrition Guidelines.
Management of vascular access in Europe. Part 1 ‐ A study of centre based policies
Authors:   For the EDTNA/ERCA Collaborative Research Programme, van Waeleghem JP , Elseviers MM , Lindley EJ 
Published: July 2012

summaryThe EDTNA/ERCA survey of the management of vascular access was the first project organised through the Collaborative Research Programme. This paper reports in the first part, on the current policies for management of vascular access which were studied using centre‐based data collected with a computer based questionnaire. The survey included 103 European centres treating a total of 13,800 chronic haemodialysis patients. 75% of patients in the participating centres were dialysed using a native arteriovenous fistula, 10% had a synthetic graft and 15% had a catheter. In most centres, well‐established hygienic precautions were used. When handling catheters, hygiene was even better. We observed that many aspects of access management varied significantly from region to region as well as between centres. The second part of this paper will relate the large differences observed in centre policies of vascular access management to individual patients' outcome parameters.
A decade review: Methods to improve adherence to the treatment regimen among haemodialysis patients
Authors: Morgan Lois 
Published: July 2012

SummaryHaemodialysis patients are asked to adhere to a very difficult treatment regimen consisting of fluid and diet restrictions, many daily medications, and usually 3 or 4 hour haemodialysis sessions three times each week. Many haemodialysis patients fail to adhere to their prescribed treatment and although this regimen is difficult, it is necessary for patients to adhere for optimal health and well‐being. It is important for nephrology nurses to know what interventions help patients overcome the barriers that keep them from adhering to prescribed treatment The purpose of this paper is to review the literature to examine the research that has been published on methods to improve adherence among haemodialysis patients. Behavioural approaches, education, and primary nursing are interventions that have been researched More research has been reported on the demographics of noncompliant haemodialysis patients than on effective methods that help patients improve adherence to the treatment regimen. Demographic characteristics do not consistently predict compliance for individual patients. Each patient is unique. Research supports the idea that the nephrology nurse should spend time with the patient on a regular basis in order to understand the factors that hinder the individual patient from adhering to the treatment regimen. The nurse who knows the patient well is empowered to develop individualised interventions aimed at reducing barriers that interfere with the patient's ability to adhere to treatment.
Vascular access monitoring evaluated from automated recirculation measurement
Authors: Lopot F. , Nejedly B. , Svárová B. , Sulková S. , Málek V. , Bodláková B. , Svára F. 
Published: July 2012

SummaryVascular access quality monitoring by means of vascular access blood flow (QVA) evaluated from automated thermodilutional measurement of recirculation with reverse needle position is described. This method provides significant advantages over conventional methods based on simple monitoring of pressures in the extracorporeal circuit and/or measurement of recirculation with normal needle position.AQVA evaluation protocol was developed and introduced into the system of primary nursing. The QVA values were found independent of the extracorporeal blood flow used during the recirculation measurement. QVA values from below 200 ml/min to over 2 l/min were seen. In general, lower values were found in diabetics compared to non‐diabetics and in females compared to males. While blood flow below 600 ml/min is considered risky for synthetic vascular grafts, native AV‐fistulae seem to remain stable and patent at a flow of 400 ml/min or even below.The method is able to detect erroneous needle placement in looped grafts, stenosis between needles, and is also well suited for effective evaluation of success/failure of interventions on access.
Internet use by patients ‐ A shift in power?
Authors: Trevitt R. , Smitherman R. , Fitzgerald L. , Whittaker C. , Ball E.A. 
Published: July 2012

SummaryTraditionally, the patient has relied on health care professionals for advice and knowledge. The unprecedented access to information offered by the Internet may challenge this relationship. To investigate this, a questionnaire was sent to 640 transplant patients. 24 responded positively and were interviewed to see if the information they found on the net had been useful, in negotiating a change in treatment or as support. Internet use was associated with younger males who had access to the net at work. 22 had found useful information although only 1 patient had negotiated a change in treatment as a result. As the Internet becomes universally available, patients will be empowered to have a larger role in maintaining their health, and support groups will be better able to help patients. To prepare to deal with this avalanche of information we need to develop a system of accreditation of Internet sites, to create our own sites and to collaborate with patient support groups.
Haemodialysis and H.I.V. infection ‐ therapeutic management
Authors: Chamton N. , Tellier E. , Zins B. , Dubreuil‐Lemaire  , Zazempa Virginie 
Published: July 2012

SummaryThe prevalence of human immunodeficiency virus among haemodialysis patients is of interest and this article discusses the management of 25 patients between 1985 and 1998 in Paris.
EDTNA/ERCA Dialysis Technology Journal Cub 2000/3 summary
Authors: Stragier André 
Published: July 2012

Two hundred and eighty nine colleagues participated in the August 2000 Journal Club. The selected discussion paper was entitled: “Why and how to monitor bacterial contamination of dialysate” by Dr Rafael Péz‐Garcia et al. from Madrid, Spain, published in Nephrology Dialysis Transplantation (2000) 15: 760–764.The authors present the rationale and discuss the methods to monitor dialysate bacterial and endotoxin levels. They offer a better insight into the complex relationship between bacterial contamination of dialysate, endotoxin and cytokines. Eventually they stress the need for complete guidelines regarding dialysate fluid quality monitoring. Please find below a condensed summary of this discussion paper, the full summary being available on the EDTNA/ERCA web site, where free on‐line subscription to this Journal Club is available.