John Sedgewick

Chronic kidney disease (CKD) is increasing in prevalence worldwide, with the largest increase occurring in individuals over the age of 65 years. Providing renal replacement therapy (RRT) to this older population will challenge health care systems, in terms of resources needed, as well as healthcare staff caring for this highly dependent group, who frequently have multiple co-morbidities. This study aimed to develop a theory that adequately accounts for the social processes involved when older people, with CKD stages 4 and 5 access treatment. The study sought to explore the concerns they had with CKD when making treatment decisions and identified how their concerns were resolved. This study employed grounded theory using the full complement of coding, categorisation, and theoretical development. Data was collected from interviews and observations of clinic consultations between patients and healthcare practitioners, from 21 older people who were at the point of making treatment decis...

ABSTRACT The discussion was initiated by a paper on the influence of a pre‐dialysis education programme on the mode of renal replacement therapy by Goovaerts et al (NDT 2005). Barriers to the uptake of self‐care treatment modalities, including late referral, limited availability of treatment options, reimbursement, support from staff and families, the requirement for a helper and the length of the training programmes for home haemodialysis (HD) were discussed by 21 participants from 12 countries.The ‘take‐home’ messages from the discussion were that to optimise the uptake of self‐care modalities, renal units should try to ensure the all patients who are able to choose are fully informed before starting dialysis, even if they are referred to the unit very late. Offering a wide range of treatment options to new patients, and allowing (or encouraging) home HD without a helper, may also increase the number of patients who start and stay on a self‐care modality. It should be possible to provide an acceptable level of training, without compromising on safety, within 3 weeks if the patient is confident with needling.

Pain is an unpleasant sensory and emotional experience and is the most common symptom experienced by renal patients. It can be caused by primary co-morbid diseases, renal replacement therapies, medication or treatment side effects, and its intensity varies from moderate to severe. Pain management in renal patients is difficult, since the distance between pain relief and toxicity is very small. This paper will provide an algorithm for pain management proposed using paracetamol, nonsteroid anti-inflamatory drugs (NSAIDs), mild and stronger opioids as well as complementary techniques. Quality of Life (QoL) and overall enhancement of the patient experience through better pain management are also discussed. To improve pain management it is essential that nurses recognise that they have direct responsibilities related to pain assessment and tailoring of opioid analgesics and better and more detailed education.

Author details: John Sedgewick RN, RMN, Renal Cert, DipN, BSc (Hons), MSc (Nurs), MSc (HSR), Cert ED, RNT, PhD (c) Programmes Director and Principal Lecturer (Nephrology), School of Health and Social Care, Teesside University and the RCN (UK) Nephrology ...

This paper highlights the importance of evidenced-based practice (EBP) and its implications to patient and health professionals working within nephrology. The need to ensure that practice is based upon best evidence should be a concern for all health care ...

It is ten years since the publication of the first edition of the Post-Basic Core Curriculum (PBCC) and following a review of this edition, by the Education Board of the EDTNA/ERCA, a second edition of the PBCC was published in 2004. This edition is currently available as a hard copy and on CD-ROM. The second edition includes changes to the structure and content of the curriculum, which reflects contemporary developments in Renal Care and Nephrology Nursing.

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.

This paper highlights the importance of evidenced-based practice (EBP) and its implications to patient and health professionals working within nephrology. The need to ensure that practice is based upon best evidence should be a concern for all health care professionals. Confusion sometimes surrounds the concept of EBP and the potential impact this may have upon patient outcomes. It is the intention of this paper to firstly demystify the process of EBP highlighting the important factors to be considered in moving towards EBP in nephrology care. Secondly, the paper draws upon a number of well-conducted research studies, which have important implications for nephrology care. These selected examples of best evidence will highlight further where ongoing work could be focused. Whilst there is much published within current literature concerning research within nephrology it is essential that practitioners are encouraged to develop the skills to critically search literature, appraise and evaluate its usefulness in developing appropriate and meaningful evidence to enhance practice and patient care.

Nephrology nursing is shaped by health policy and economics as well as by social trends. Importantly, the care of patients with renal failure must be a collaborative activity and one that draws upon the unique contribution of every member of the multidiscipiinary team. ...

Health-care staff are increasingly faced with assisting patients and families to adjust to the demands imposed by end-stage renal disease. ESRD imposes major life changes upon patients and families, who are required to cope with a new way of living. Patients and their ...

This major textbook is the first British text, written by nurses for nurses, to give full coverage of the specialisation of renal nursing. Early chapters address the underlying scientific principles of renal physiology and dialysis, and consider the differing physical and ...