EDTNA/ERCA European Dialysis and Transplant Nurses Association/European Renal Care Association Dresden 2015
Patient-centred Renal Care – A Multidisciplinary Approach to Holistic Health
Journal of Renal Care

EDTNA/ERCA Journal 4.2003

A case study - Initiation of haemodialysis

Georgia Gerogianni, Haemodialysis Unit, Tzaneio hospital, Athens, Greece.

Address for correspondence
Georgia Gerogianni,
Ariadnis 1, Ano Kypseli
Post code: 113 64
Athens,
Greece 
Phone Number: 0030 210 8615701
Mobile:003 6976209753 

Biodata
Georgia Gerogianni, PGDip, MSc in Advanced Nursing obtained her nursing qualification in 1997. She completed her Masters in Advanced Nursing at the University of Ulster at Jordanstawn, in Belfast, Northern Ireland. Georgia is now working in a dialysis unit in Tzaneio hospital in Athens and has three years working experience in the dialysis setting. She has participated in several conferences and meetings concerning dialysis care.

Key words
Haemodialysis; End-Stage Renal Disease; Nursing Diagnosis; Case Study

Summary
End-Stage Renal Disease (ESRD) is a chronic failure of normal kidney function, which is precipitated by a number of factors, such as diabetes, pyelonephritis, hypertension, and polycystic kidney disease1. The loss of kidney function is gradual, and many patients do not have any symptoms until the end stage of the disease. Killingworth and Van Den Akker2 point out that people undergoing haemodialysis have to comply with a wide range of medications and restrictions, which affect both their physiological and psychological status.

The paper presents a case study of a woman with ESRD, requiring initiation of haemodialysis. An assessment of the patient’s health needs is addressed, followed by the implementation and evaluation of the nursing process. Finally, the analysis of the overall plan used in the case study is presented.

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A nurse led central line insertion service

J. Casey and J. Davies. Arrowe Park Hospital, Merseyside, UK.

Address for Correspondence
Jon Casey,
Advanced Nurse Practitioner,
Ward 31, Renal Unit,
Arrowe Park Hospital,
Wirral,
Merseyside,
CH49 5PE,
UK
E-MAIL: jonathan.casey@WHNT.NHS.UK

Biodata
Jonathan Casey MSc. RGN DipN. works as an Advanced Nurse Practitioner and is a long-standing member of the EDTNA. He has published widely and is providing the lead in developing advanced nursing in the UK.

Jon Davies, RGN, DipN, is a Vascular Access Specialist Nurse working at Arrowe Park Hospital, Wirral, Merseyside.

Key words
Advanced Nurse Practitioner; Central Venous Catheters; Line Insertion

Summary
Advanced 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.

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A University accredited renal nursing course delivered by distance learning

J. Hurst, City University, London, UK

Address for correspondence
School of Nursing and Midwifery
City University
Philpot St
Whitechapel
London
E1 2EA
UK

Biodata
Judith Hurst, RGN, BA (Hons), PGDip (EDN), MSc is a Teaching Fellow and Lecturer in Renal Care at City University. She has worked in renal care since 1993, and now specialises in delivering multiprofessional renal education via the classroom and e-learning media. Research interests are in the areas of distance and e-learning, and haemodialysis. Judith has published in nephrology and education journals and presented at national and international conferences on renal care, and e learning. She is a member of the accreditation team and the EB of EDTNA/ERCA.

Key words
Distance learning; education; renal nursing

Summary
Continuous professional development (CPD) is limited in some regions of the UK and within Europe generally. This is compounded for all by limited resources for course fees and the lack of study leave granted away from the clinical area for full-time courses. This is set against recommendations from national and European governments and renal clinical guidelines concerning expectations of CPD and competency levels of renal nurses 1,2. In the past renal nurses have been trained in all areas of the speciality by local Schools of Nursing linked to renal units. However, since the formation of Trusts in 1990 education delivery has been ring-fenced and separated from the control of local hospitals by Schools of Nursing being incorporated into Institutes of Higher Education. That has led in some instances to a rationalising of post registration education delivery for some geographical areas. This paper will discuss the development and implementation of a distance learning renal care course taking into consideration the clinical, academic and educational requirements necessary for effective education and training at the post basic level.

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Accreditation of Post-basic nephrology courses within the EDTNA/ERCA

Judith Hurst, Nicola Thomas, John Sedgewick, Micheal Reichardt, Education Board, EDTNA/ERCA

Address for correspondence
School of Nursing and Midwifery
City University
Philpot St
Whitechapel
London
E1 2EA
UK

Biodata
Judith Hurst, RGN, BA (Hons), PGDip (EDN), MSc is a Teaching Fellow and Lecturer in Renal Care at City University. She has worked in renal care since 1993, and now specialises in delivering multiprofessional renal education via the classroom and e-learning media. Research interests are in the areas of distance and e-learning, and haemodialysis. Judith has published in nephrology and education journals and presented at national and international conferences on renal care, and e learning. She is a member of the accreditation team and the EB of EDTNA/ERCA.

Key words
Accreditation; Nephrology; Courses; EDTNA/ERCA

For further information about the accreditation process and how to apply, please see the details on the EDTNA/ERCA website under the EB section www.edtna-erca.org

Summary
This 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.

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Burnout in Renal Care Professionals

Stella Kotzabassaki RN., Ph.D., Athens, Greece.
Stylianos Parissopoulos RN., Sheffield Teaching Hospitals NHS Trust, UK.

Address for correspondence
Stella Kotzabassaki, RN. Ph.D.,
Trifyllias 38 Ano Ilisia 157 72’
Athens,
Greece.
Phone: +3210 7758726,
Fax: +3210 5385615
E-mail: skotzab@teiath.gr

Biodata
Dr. Stella Kotzabassaki is Associate Professor in the Nursing B Department of the Technological Educational Institution (TEI) of Athens. She has a long history of collaboration with the Hellenic Nephrology Nurses’ Association regarding educational activities. Dr. S. Kotzabassaki is the author of several articles published in Greek and International Nursing Journals and she is also involved in many European and International activities within the Erasmus-Socrates and other programmes.

Key words
Renal care; renal patient; stress; burnout; coping; social support

Summary
Burnout 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. 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.

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Discovering the Culture of Haemodialysis Units: An Ethnography

C. Ashwarden, University of Southampton, UK

Address for correspondence
Cordelia Ashwanden
Butts Legh,
School Lane,
Cookham.
Berks. SL6 9QJ
Email Cordieash@aol.com

Biodata
Cordelia Ashwanden has presented many papers and written articles for national and international conferences and journals.  She is now finishing a PhD in renal nursing at the University of Southampton, having retired as manager of a renal unit in the UK.

Key words
Culture; Dialysis units; Partnerships

Summary
The increasing renal population and the lack of resources available to meet this need means that every renal patient should get 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.

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Editorial

I am delighted to present this special education issue for the EDTNA/ERCA journal. The Education Board (EB) of the Association is working on many interesting projects and this journal issue informs and discusses the progress of these projects, alongside papers on educational topics that have been submitted by our members.

The EB is proud that many of the Association’s educational activities are at the forefront of those provided by other specialist associations in Europe. Waltraud Küntzle (Past President) and myself represented the Association at the October 2002 meeting of the PCN (the European Permanent Committee of Nurses). Representatives from national nursing Associations and specialist nursing Associations were present, and it was clear that other associations wished to learn from our experience in developing educational resources such as the European Post-Basic Core Curriculum (CC) in Nephrology Nursing that was the first of our major publications. It is important to remember that the publication of this Curriculum had enormous success in achieving recognition for post-basic nursing education in nephrology, such as in Germany.

Since 1995, when the Post-Basic CC was published, the EB has worked on two main projects – the accreditation of post-basic courses in nephrology nursing and publication of the European Basic Core Curriculum (BCC) in Nephrology Nursing. Within this journal there are papers outlining the progress of these two projects and thanks must go the enormous amount of work put in by members of the EB in achieving so many on-going objectives.

EDTNA/ERCA continues to be committed to providing continuing professional development (CPD) activities. The Association is working towards providing a range of opportunities for CPD, such as national seminars organised by Key Members plus newer schemes such as the on-line learning modules provided by the EB. If you have not visited the Homepage to view these materials for yourself, then visit www.edtna-erca.org, click on education and from there you will view the modules. Modules are for all our members from any discipline and are updated monthly. They are a way of keeping you updated with current renal care and offer a chance for you to reflect on your practice. Recent topics have included vascular access, water quality, nutrition and quality of life. The modules can be undertaken individually or may be used for groups of students.

On a final note, I would like to inform you about the future plans for CPD. The EB wishes to develop guidelines for CPD (recommendations for minimum updating/study requirements for all renal staff) and a greater range of on-line learning. Both were rated highly in last year’s questionnaire on products and services that so many of you completed in The Hague. At the time of writing the EB is writing a strategy on developing both these projects, so any comments/input from you, the members, are most welcome.

Happy Learning!
Nicola Thomas
EDTNA/ERCA Education Board Chair

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Education to reduce potassium levels in adolescent, haemodialysis patients

Aysun Dadeviren, BScN, MSc.
Dialysis Department SSK Niþantaþý, Istanbul, Turkey.

Sevim Savaþer, BScN, Prof.
Assistant Director of Florence Nightingale College of Nursing, Istanbul University, Istanbul, Turkey.

Address for correspondence
Sevim Savaþer
Ýstanbul Üniversitesi Florence Nightingale Hemþirelik Yüksekokulu 
Abide-i Hürriyet Cad. 80270 Çaðlayan-Þiþli
Ýstanbul
Turkey
Phone –Fax: + 90 212 224 49 90
E-mail: sevimsavaser@hotmail.com

Biodata
In 1978 Sevim Savaþer worked in the Paediatric Nursing Department of Florence Nightingale College of Nursing, Istanbul University. Since 1995 she has worked with the Administration Board as Assistant Director.

Key words
Haemodialysis; Nutrition; Hyperkalaemia; Education; Adolescent

Summary
A semi-experimental survey was carried out. The aims included assessing how knowledgeable adolescents undergoing haemodialysis treatment were regarding hyperkalaemia, and determining how effective an education programme in preventing hyperkalaemia would be. 31 volunteers (twelve girls and nineteen boys), who had two or three haemodialysis treatments a week, were included in the study. Data were obtained through a questionnaire, the answers to which were written down for each participant separately by the researcher. A manual was prepared with the aim of educating children in hyperkalaemia, the participants were taught lessons in groups of two to three at a time. The education programme was completed in eight sessions. At the end of the programme each participant was given a copy of the manual. A month after the education programme, participants were asked to refill the section of the aforesaid questionnaire. The children’s’ scores in this section had increased, and their blood potassium levels had significantly decreased (p=0.02).

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The hurdles of migrant nurses

Cristeta Campos Funtera, Tipton Dialysis Centre, West Midlands, UK

Address for correspondence
Cristeta Campos Funtera,
Tipton Dialysis Centre,
West Midlands,
UK

Biodata
Cristeta Campos Funtera BSN, RN registered as a nurse in 1997. Cristeta has worked in haemodialysis since 1999 and is presently a staff nurse in one of the satellite clinics of Fresenius Medical Care UK.

Key words
International Recruitment; Foreign Nurse; Adaptation; Challenges; Retention

Summary
The 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 the 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 the 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 working in a different system of health care.

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