Hemodialysis: The Rope Ladder and the Buttonhole Techniques
When a person’s kidney function starts to deteriorate, the ability to filter wastes and fluid begins to decrease, thus, leading to the buildup of toxins in the body. Treatment options available for patients living with kidney failure are very limited. Hemodialysis is one type of treatment that can be used for kidney failure patients. This treatment replaces the function of the previously working kidney(s), filtering blood and ridding the body of waste products, as well as excess fluid that is not needed. This is done by a machine specific for hemodialysis called a dialyzer (Dialysis Needles, Self-Cannulation and the Buttonhole Technique , 2014). The dialysate is fluid used in the dialyzer that helps with the filtering of the blood within the machine. This fluid is made up of water that has been purified and contains potassium, sodium, magnesium, chloride, calcium, and dextrose. If pH needs to be balanced, bicarbonate will be added to this solution (Nettina, 2014). In order for hemodialysis to be used, an arteriovenous fistula must be surgically prepared by a physician. A fistula is when an artery and a vein are connected directly to one another resulting in a more perfused vein (Dialysis Needles, Self-Cannulation and the Buttonhole Technique , 2014). The benefit of having a vein receive larger amounts of blood is that it causes the vein become larger and stronger; therefore, it can handle the repeated cannulation placements that are needed to perform hemodialysis (Vascular Access for Hemodialysis, 2010). Fistulas take some time to mature but once they have matured, they are ready to be accessed and used for hemodialysis treatment.
The more commonly known and...
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...ole": A Novel Technique for a Regional Australian Renal Service. Journal of Renal Care 2009 , 114-119.
Ludlow, V. (2010). Buttonhole Cannulation in Hemodialysis: Improved Outcomes and Increased Expense--Is it Worth it? The CANNT Journal , 20 (1), 29-37.
Mott, S. (2010). A How-To Manual: The Art of Teaching Buttonhole Self-Cannulation. Retrieved March 10, 2014, from Home Dialysis Central: http://www.esrdnet15.org/qi/ff/buttonholeprocedure.pdf
Nettina, S. (2014). Hemodialysis. In S. Nettina, & S. Magee (Ed.), Lippincott Manual of Nursing Practice (10th ed., pp. 786-787). Ambler, Pennsylvania , USA: Wolters Kluwer Health Lippincott Williams and Wilkins.
Vascular Access for Hemodialysis. (2010, September 2). Retrieved March 10, 2014, from National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC): http://kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess/
Kidney Care is comprised of U.S. dialysis and related lab services, ancillary services and strategic initiatives, including international operations and corporate administrative support. The U.S. dialysis and related lab services business is the largest line of business, which is a leading provider of kidney dialysis services in the U.S. for patients suffering from chronic kidney failure, also known as end stage renal disease (ESRD). The HCP division is a patient- and physician-focused integrated healthcare delivery and management company with over two decades of providing coordinated, outcomes-based medical care in a cost-effective manner ("DaVita Healthcare Partners 10-K Annual Report" 2015). STp(c) Segmentation, targeting, and positioning together comprise a three stage process.
This machine used an intravenous drip which was hooked up to the patient. The IV would start dripping a solution of saline. When the patient was ready they pushed a button and this solution would stop dripping. At this time the machine would release a drug called thiopental, better known as sodium pentothal, a general anesthesia for sixty seconds. After this the patient would be in a coma. A timer would stop the first drug and the release the next one called potassium chloride. This drug will cause a heart attack and the patient will die in their sleep. (Gibbs, McBride-Mellinger; PBS.org.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Different studies had different result numbers or different percentage reduction rates which was primarily based on their indifferences in regards to study design utilized and sample size. As evidenced by research results (Magers, June 2013) and (Welden, 2013), these showed a reduction of urinary catheter days resulted in reduced CAUTI rates. Though different outcome results between the different research studies, they all strongly significantly supported the notion that a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter compared with a no protocol is essential to help in the reduction of CAUTIs. Interpreting these results, (Meddings et al., 2013) showed a drop greater than 52% in CAUTIs and a decrease in catheterization by 37%. The study results from the six scholarly research study articles showed nearly similar or corresponding outcomes. The results were significant enough to support the PICO question. In general, though the difference in sample size, the results still strongly supported excellent outcomes when a nurse-driven protocol is used to evaluate the necessity of continued urethral catheter use. (Chen et al., 2013, para.
Ms. Bardsley functions as a hemodialysis liaison and leader in clinical practice with the following roles: charge nurse, preceptor, and mentor for her colleagues. She is the resource person for the Hct-Line monitoring tool. The tool is used to monitor patient’s fluid removal during treatment to avoid hypotensive episodes associated with decreased perfusion to the heart. She routinely monitors the patient outcomes which to date has resulted in 0 admissions. She recently updated the policy to make it more user friendly for the staff and to maintain staff competency.
* In the first dialysis tube (bag A), we would insert ten mL of one
“The Nephrology Nursing Journal” was initially published in 1974, and 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 (ANNA, 2015). 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 (ANNA, 2015). It is designed to meet the educational and information needs of nephrology nurses in a variety of roles at all levels of practice, while also serving as a source of knowledge for non-nephrology nurses. (ANNA, 2015). Its content expands the knowledge base for nephrology nurses, stimulates professional growth, guides research-based practice, presents new technological developments, and provides a forum for review of critical issues promoting the advancement of nephrology nursing practice (ANNA, 2015).
After further multidisciplinary team meetings with the involvement of John the treatment option of automated peritoneal dialysis was implemented (NSF 2004). Once the Tenchkoff catheter had been inserted, education and training completed John was ready for discharge home.
Currently there are two types of renal replacement therapy. The original dialysis which we called it hemodialysis used for patients with chronic renal failure, needs the patients to come to hospital 2-3 times per week. This type of dialysis called the intermittent hemodialysis .However the intermittent hemodialysis is difficult to do it in the intensive care population with acute renal failure because of the hemodynamic instability and those type of patients usually are the most sick and critically ill patients within the intensive care units and have multiorgan dysfunctions, so medically is too difficult to do for them intermittent hemodialysis. In addition intermittent hemodialysis will increase the mortality and morbidity among them. Within the modern intensive care units new way of dialysis has been developed 30 years ago called continuous renal replacement therapy (CRRT).The definition of (CRRT) is any extracorporeal blood purification therapy intended to substitute for impaired renal function over an extended period of time and applied for or aimed at being applied for 24 hours/day, Bellomo R., Ronco., Mehata R. The CRRT was found because the traditional way of ...
Quinan, P. (2007). Control and coping for individuals with end stage renal disease on hemodialysis: A position paper. CANNT Journal, 17(3), 77-84.
This article describes the choices for treatment: hemodialysis, peritoneal dialysis, and kidney transplantation. It gives the pros and cons of each. It also discusses diet and paying for treatment. It gives tips for working with your doctor, nurses, and others who make up your health care team. It provides a list of groups that offer information and services to kidney patients. It also lists magazines, books, and brochures that you can read for more information about treatment.
In the older population, dehydration can also be caused by ineffective kidneys, they may not be able to hydrate themselves due to a disability such as stroke, or they chose not to intake fluids. Hydration is an important fac...
As Burns and Grove (2001) & Polit and Hungler (1997) as cited in Ingham-Broomfield (2008 p.104) mentioned that the primary purpose of the literature review is to discuss what is known, gain broad background and understanding of the available information related to the study. As Coughlan, Cronin, and Ryan (2007) stated that literature review should also help to identify any gaps in the literature relating to the problem and suggest how those gaps might be filled. The authors of this article has not provided any review of literature and this could misinform the reader what the main focus of the study; however, several appropriate references were used in the background. The terms used in the key concepts are adequately defined and consistent with the topic. The background of the study introduces the previous knowledge or what is already known which is to investigate the effectiveness of an ATP designed to help ESRD patients to cope with stressors while receiving haemodialysis treatment.
On these occasions, I rely on my nursing assessment, evaluation, and interventions, collaborative skills, and scientific knowledge to make sound clinical judgments for the benefit of my patients. As a hemodialysis nurse, I will persevere to comply with innovation in nursing practice, EBP, research, and education. I believe growth requires generation of innovative, improved ideas and practices for the betterment of the organization and patient satisfaction. For this reason, I will embrace technological advancements; empower front line staff to embrace change and innovation; and motivate staff to be change agents on the floor with the aim to provide better quality of care for our
Chronic Kidney Disease. Mayo Foundation for Medical Education and Research, 2014. Web. 20 May 2014.