The Role of Prevention and Standardized Care in Improving CKD Outcomes

Slowing Chronic Kidney Disease Progression

Most nurses have worked with patients with chronic kidney disease (CKD). Their condition may have been related to diabetes, high blood pressure, an acute infection, or other assaults on the kidney. I’ve tended to see a diagnosis of CKD as the beginning of an inevitable decline. Certainly, “prevention” didn’t seem a relevant concept at this point; my role was to assess and monitor, teach and support, and hope for the best.

Fig. 1. The Nephron. Blood flows into the nephron through the glomerulus. Filtrate from the glomerulus flows into Bowman’s capsule, then through the proximal tubule, the loop of Henle, and the distal tubule, a series of tubules that modifies the filtrate primarily by reabsorbing […]

2017-03-14T12:02:17-04:00February 15th, 2017|Nursing, Public health|0 Comments
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AJN in February: Improving CKD Outcomes, Nurses and Patient Safety, Moral Distress, More

The February issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: “Improving Outcomes for Patients with Chronic Kidney Disease: Part 1”

The burden of chronic kidney disease (CKD) is rising both in this country and worldwide. An estimated 10% to 15% of U.S. adults are currently living with CKD. The greatest opportunities to reduce the impact of CKD arise early, when most patients are being followed in primary care; yet many clinicians are inadequately educated on this disease. This two-part article aims to provide nurses with the basic information necessary to assess and manage patients with CKD. This month, part 1 offers an overview of the disease, describes identification and etiology, and discusses ways to slow disease progression. Part 2, which will appear next month, addresses disease complications and treatment of kidney failure.

CE Feature: “Nursing’s Evolving Role in Patient Safety”

In its 1999 report To Err Is Human: Building a Safer Health System, the Institute of Medicine suggested that between 44,000 and 98,000 Americans die annually as a result of medical errors. The report urged health care institutions to break the silence surrounding such errors and to implement changes […]

2017-01-30T10:39:50-05:00January 30th, 2017|Nursing|0 Comments
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Breathing Training May Ease Depression in Dialysis Patients: Study Findings

By Sylvia Foley, AJN senior editor

It’s estimated that depression afflicts between 25% and 50% of people who have chronic kidney disease. And depression has been associated with numerous adverse outcomes in this population, including poor sleep, reduced quality of life, and higher rates of hospitalization and death. Researchers Siou-Hung Tsai and colleagues wanted to know whether teaching patients a basic relaxation technique—deep, slow breathing—could alleviate depressive symptoms.

To learn more, they developed a four-week intervention and conducted a trial. The intervention included instruction by a dialysis nurse trained in deep breathing techniques, additional audio device–guided instruction, and guided exercises. The authors report on their findings in this month’s CE–Original Research feature, “The Efficacy of a Nurse-Led Breathing Training Program in Reducing Depressive Symptoms in Patients on Hemodialysis.” Here’s a brief summary.

Objectives: The purpose of this randomized controlled trial was to examine the efficacy of a nurse-led, in-center breathing training program in reducing depressive symptoms and improving sleep quality and health-related quality of life in patients on maintenance hemodialysis.
Methods: Fifty-seven patients on hemodialysis were randomly assigned either to an eight-session breathing training group or to a control group. The Beck Depression Inventory II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Medical Outcome Studies 36-Item Short Form Health Survey (SF-36) were used to assess self-reported depressive symptoms, sleep quality, and health-related quality of life, respectively.
Results: The intervention group exhibited significantly greater decreases in BDI-II scores than did the control group. No significant differences in PSQI change scores were observed between […]

2017-07-27T14:41:22-04:00April 7th, 2015|nursing perspective, nursing research|1 Comment
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AJN in April: Deep Breathing for Dialysis Patients, Isolation Care, Sleep Loss in Nurses, More

AJN0415.Cover.OnlineOn our cover this month is Pablo Picasso’s Le Rêve (The Dream). We chose this portrait of a woman in a restful pose to highlight the importance of proper sleep to a person’s overall health and well-being. Unfortunately, not many Americans are able to get the proper amount of rest. The Institute of Medicine (IOM) estimates that 50 to 70 million U.S. adults have chronic sleep and wakefulness disorders—and nurses are not immune.

Between long shifts and the stressful nature of their jobs, nurses are especially vulnerable to not getting an adequate amount of quality sleep. Fatigue from lack of sleep may diminish the quality of nursing care. Sleep loss has been linked to impaired learning, memory, and judgment and is also associated with a slew of chronic diseases. This month’s CE feature, “The Potential Effects of Sleep Loss on a Nurse’s Health,” describes the acute and chronic effects of sleep loss on nurses, strategies nurses can use to improve the quality of their sleep, and institutional policies that can promote good rest and recuperation.

This feature offers 2 CE credits to those who take the test that follows the article. You can further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad […]

2016-11-21T13:02:46-05:00March 27th, 2015|career, nursing perspective, nursing research|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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