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Nephrology Nursing Journal News Briefs
Fewer Nurses Mean Bigger Risks for Chronic Hemodialysis Patients, Study Shows
A wealth of evidence has shown hospital patients get better care when there are more RNs on duty. According to a recent report in Nephrology Nursing Journal (NNJ), the same outcomes apply to patients receiving chronic hemodialysis treatments.
In the March-April 2008 issue of NNJ, Charlotte Thomas-Hawkins and her co-authors examine the effects of RN staffing levels and patient care in chronic hemodialysis units. Survey data gleaned from 422 RNs clearly showed high patient-to-RN ratios resulted in more adverse events and tasks left undone by nurses.
The survey respondents, who were randomly selected from members of the American Nephrology Nurses Association (ANNA), self-reported the results in a detailed questionnaire. All of the respondents worked in freestanding hospital or corporate-owned dialysis units, or in a hospital-based dialysis unit. Results showed higher patient-to-RN ratios were significantly related to higher frequencies of shortened dialysis treatments, skipped treatments and patient complaints. Similarly, when staffing hit a mark of up to 12 patients per RN, there were more adverse events such as infection, pneumonia, blood clots and excess bleeding.
The authors emphasize the study findings are of utmost importance as health care institutions continue to experience a growing shortage of RNs. They emphasize the need for more research, as well as strengthened policies at the federal, state and dialysis organization levels supporting the skills and services of professional RNs. (Relationships Between Registered Nurse Staffing, Processes of Nursing Care, and Nurse-Reported Patient Outcomes in Chronic Hemodialysis Units, Charlotte Thomas-Hawkins, PhD, RN; Linda Flynn, PhD, RN; and Sean P. Clarke, PhD, CRNP, FAAN; Nephrology Nursing Journal; March-April 2008; www.annanurse.org/journal)
Study Gives Voice to Patients Living with Chronic Kidney Disease
Achieving quality of life is not easy for people living with chronic kidney disease (CKD). Because the illness is incurable, patients must become adept at self-managing their care as well as learning how to juggle the complexities of CKD with their other life roles, according to a recent report in Nephrology Nursing Journal (NNJ).
Lucia Costantini and her co-authors explored 14 patients experiences via face-to-face interviews and questionnaires. Participants explained how they felt when they realized CKD is chronic, how they learned to live with the disease, and the ways they manage their illness. Patients also shared their frustration with getting appropriate information from health care providers and guidance about proper diet, fluid and medications.
Clearly, there are significant unmet needs for people with CKD, Costantini writes, also pointing out a lack of research in this area. Our findings suggest that people with early CKD need more disease-specific education in conjunction with collaborative healthcare partnerships to successfully self-manage their illness.
Nurses can help fill the care gap because they are uniquely trained to address both the biological and psychosocial ramifications of illness, Costantini says. (The Self-Management Experience of People with Mild to Moderate Chronic Kidney Disease, Lucia Costantini, MN, RN; Heather Beanlands, PhD, RN; Elizabeth McCoy, PhD, RN; Daniel Cattran, MD; Michelle Hladunewich, MD; and Daphene Francis, BScN, RN; Nephrology Nursing Journal; March-April 2008; www.annanurse.org/journal)
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Nephrology Nursing Journal is a refereed clinical and scientific resource that provides current information on a wide variety of subjects to facilitate the practice of professional nephrology nursing. Its purpose is to disseminate information on the latest advances in research, practice, and education to nephrology nurses to positively influence the quality of care they provide. For more information, visit www.annanurse.org/journal.