Hemodialysis Nurses Research Articles

The Psychological Experience of Nurses Carrying Out Hemodialysis While Caring for Patients With COVID-19 in Indonesia

Several studies have been conducted to assess the impact of the COVID-19 pandemic on mental health. However, few studies have been conducted in Indonesia to investigate the impact of the pandemic on the psychological experiences of nurses in carrying out hemodialysis (HD) while caring for patients with COVID-19 in Indonesia. Thus, this was the purpose of this study. The Colaizzi phenomenological approach was applied. This study included 20 HD nurses. Qualitative approaches were used to provide an overview of the nurses’ psychological state during the pandemic. This study identified three primary themes: dealing with uncertainty, personal care and protection from COVID-19, and psychological resilience. The HD nurses were affected by the pandemic, and this study’s findings can be utilized by policymakers to make judgments about how to respond. The results may also help health workers and volunteers recognize mental health issues and develop mental health rehabilitation programs for HD nurses affected by the COVID-19 pandemic.
 Keywords: COVID-19, hemodialysis, live experience, nurse, psychological

Transformation of Clinical Nursing Practice Following a Caring-based Educational Intervention: A Qualitative Perspective.

IntroductionHemodialysis (HD) patients experience numerous physical and psychological symptoms on a daily basis. These symptoms have a heavy impact on their quality of life, which is a key indicator of their survival in the short term. Numerous empirical studies have shown that the quality of the nurse-patient relationship (NPR) is essential in promoting positive outcomes for patients. When patients receive caring, their autonomy and independence grows, their sense of hope increases, their quality of life improves, and their sense of satisfaction with nursing care received rises. Inversely, the presence of dehumanizing practices in hemodialysis settings can contribute to delay healing for patients. In light of the importance of the quality of the relationship between nurses and HD patients and of the benefits to be had from a quality relationship, an educational intervention based on Watson's Theory of Human Caring was delivered to HD nurses.ObjectiveThe purpose of this study was to explore qualitatively the perceptions of nurses working with HD patients in French-speaking Switzerland regarding changes to their clinical practice after receiving an educational intervention intended to reinforce caring attitudes and behaviors towards patients.MethodsThe method used was that of consensual qualitative research (CQR). Sixteen semi-structured interviews were conducted with hemodialysis nurses post-intervention.ResultsThe results evidence a transformation of clinical nursing practice illustrated by three core ideas: (1) caring practice was reinforced; (2) new practices emerged; and (3) some limitations appeared.ConclusionIn these times of global pandemic where the issue of the humanization of nursing care is front and center, this professional development activity helped reinforce caring-based practice. This practice needs to be developed within the various care units in order to guarantee and promote quality of care and patient safety.

The Method and Effect Analysis of High Quality Nursing in Hemodialysis Nursing

The Method and Effect Analysis of High Quality Nursing in Hemodialysis Nursing

Effects of an educational intervention to strengthen humanistic practice on haemodialysis nurses\u2019 caring attitudes and behaviours and quality of working life: a cluster randomised controlled trial

BackgroundNurses are trained to establish a trusting relationship with patients to create an environment promoting patients’ quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson’s Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design.MethodsOne hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study.ResultsThe intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention.ConclusionsResults support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices.Trial registrationNCT03283891.

Impact of burnout among dialysis nurses providing high-quality care in Butuan City, The Philippines

IntroductionHemodialysis (HD) nurses are prone to multiple and more overt forms of stress that could eventually lead to burnout. Burnout has detrimental effects on affected nurses and may jeopardize patient welfare and quality of treatment.PurposeThe purpose of this study was to assess burnout among nurses working at the dialysis centers of Butuan City, The Philippines and its impact on providing high-quality nursing care to their patients.Materials and methodsThe researchers surveyed the six hemodialysis centers in Butuan City, Agusan Del Norte, The Philippines. The study participants were forty-four (44) hemodialysis nurses. The researchers used a four-part questionnaire to examine burnout and nursing care quality. The questionnaire was used to assess the impact of burnout on hemodialysis nurses and the quality of nursing care. The parameters used included the extent of interpersonal and intrapersonal factors that modify burnout and the relationship between burnout and nursing care quality.ResultsThe results showed that most of the respondents were between the ages of 26 and 30 years (29.55%), female (70.45%), single (65.90%), and have 1-3 years of hemodialysis work experience (45.5%). These demographic characteristics of the respondents implied that female HD nurses outnumbered their male counterparts in Butuan City. The results also indicated that there was no statistically significant difference between the intrapersonal and interpersonal factors of burnout and the respondents’ demographic profiles (p>0.05). There was, also, no significant association between the quality of nursing care and reduced personal achievement (r = 0.00042). However, there was a significant association between the quality of nursing care and emotional exhaustion and depersonalization (r = 0.517 and r = 0.419, respectively). ConclusionsBurnout has a significant impact on the quality of nursing care among hemodialysis nurses of Butuan City, The Philippines. HD nurses must focus on developing workplace practices that will help to reduce burnout and empower them to foster healthy connections with their co-workers. This provides a peaceful and productive work environment that may help ease tensions and burnout.

Hemodialysis Nursing Analysis of Patients with Renal Failure Complicated with Cardiovascular Disease

Hemodialysis Nursing Analysis of Patients with Renal Failure Complicated with Cardiovascular Disease

Assessing Resources in a Population of Hemodialysis Patients: A New Approach to Improve Quality of Care

Hemodialysis patients constitute a vulnerable population. Their health needs are considerable and they often present psychological symptoms such as depression and anxiety. Empirical studies have demonstrated the efficacy of positive psychology interventions to enhance the well-being of patients and alleviate their depressive symptoms. One such intervention consists in identifying and mobilizing patient resources to activate their recovery. An intervention of the sort was implemented in Switzerland with hemodialysis nurses using AERES, a novel self-assessment instrument. AERES covers 31 domains under three dimensions: personal characteristics/qualities, hobbies/passions, and social/environmental resources. The aim of this qualitative study was to explore hemodialysis nurse perceptions of the use of this instrument. Sixteen hemodialysis nurses were recruited in six hospitals in French-speaking Switzerland and interviewed after delivering the intervention. A consensual qualitative research method was used to analyze the data. Results showed that the resources instrument was easy to administer and beneficial to patients and health professionals. Patient wellbeing became the top priority for the nurses and new interventions centered on patient resources were undertaken. Quality of patient care was improved. Nurses perceived this positive psychology instrument as a means of creating a positive relationship with patients and supporting them emotionally. Assessing the resources of this vulnerable population can provide health professionals with a powerful tool to understand patient intact resources, which can be used to alleviate symptoms and foster wellbeing.

Perbedaan Tekanan Darah Sebelum dan Sesudah Exercise Intradialysis Pada Pasien Hemodialisis di Unit Hemodialisis Rumah Sakit Panti Rahayu Gunung Kidul

ABSTRACT
 Background:Hemodialysis defines as a process of cleaning the blood from waste substances through a filtering process outside the body. Patients with chronic renal failure undergoing hemodialysis often experience complications including hypotension. Several references state an alternative intervention to prevent complications of hypotension in hemodialysis patients with an Intradialytic exercise. Intradialytic exercise is a planned and gradual form of exercise that includes various stages of flexibility exercise, strengthening exercise and cardiovascular exercise performed during hemodialysis. Intradialytic exercise is aimed to improve the work of the heart, respiration and improve hemodialysis regulation for the better.
 Objective:This study was aimed to determine the difference in blood pressure before and after intradialytic exercise in patients undergoing hemodialysis.
 Methods:This research design used a quasi-experimental design with pre-test and post-test with control design. The samples were 38 respondents who taken by total sampling at the Hemodialysis Unit of Panti Rahayu Hospital. The samples were divided into the intervention group who undertook intradialytic exercise for 4 weeks, each respondent experiences twice a week, while the control group who did routine hemodialysis and independent exercise.
 Results:The results showed that the distribution of the characteristics of the respondents was 51-54 years old (18.41%) the sex was mostly male (63.2%) Most of them (55.3%) underwent hemodialysis for less than 2 years. Statistically, it was known that there was no significant difference in blood pressure before and after intradialytic exercise inside patient’s body of the control and intervention groups. There was no significant difference in blood pressure between the intervention group compared to the control group, but there was a dynamic difference in blood pressure in patients who did intradialytic exercise.
 Conclusion:There was dynamics of differences in blood pressure in patients undergoing intradialytic exercise, it is recommended that hemodialysis nurses at Panti Rahayu Hospital take care patients during hemodialysis so that these interventions are routinely carried out.

Perbedaan Tekanan Darah Sebelum dan Sesudah Exercise Intradialysis Pada Pasien Hemodialisis di Unit Hemodialisis Rumah Sakit Panti Rahayu Gunung Kidul

ABSTRACT
 Background: Hemodialysis defines as a process of cleaning the blood from waste substances through a filtering process outside the body. Patients with chronic renal failure undergoing hemodialysis often experience complications including hypotension. Several references state an alternative intervention to prevent complications of hypotension in hemodialysis patients with an Intradialytic exercise. Intradialytic exercise is a planned and gradual form of exercise that includes various stages of flexibility exercise, strengthening exercise and cardiovascular exercise performed during hemodialysis. Intradialytic exercise is aimed to improve the work of the heart, respiration and improve hemodialysis regulation for the better.
 Objective: This study was aimed to determine the difference in blood pressure before and after intradialytic exercise in patients undergoing hemodialysis.
 Methods: This research design used a quasi-experimental design with pre-test and post-test with control design. The samples were 38 respondents who taken by total sampling at the Hemodialysis Unit of Panti Rahayu Hospital. The samples were divided into the intervention group who undertook intradialytic exercise for 4 weeks, each respondent experiences twice a week, while the control group who did routine hemodialysis and independent exercise.
 Results: The results showed that the distribution of the characteristics of the respondents was 51-54 years old (18.41%) the sex was mostly male (63.2%) Most of them (55.3%) underwent hemodialysis for less than 2 years. Statistically, it was known that there was no significant difference in blood pressure before and after intradialytic exercise inside patient’s body of the control and intervention groups. There was no significant difference in blood pressure between the intervention group compared to the control group, but there was a dynamic difference in blood pressure in patients who did intradialytic exercise.
 Conclusion: There was dynamics of differences in blood pressure in patients undergoing intradialytic exercise, it is recommended that hemodialysis nurses at Panti Rahayu Hospital take care patients during hemodialysis so that these interventions are routinely carried out.

Perceptions of Multidisciplinary Renal Team Members toward Home Dialysis Therapies.

Patients with ESKD are encouraged to pursue home dialysis therapy with the aims of improving quality of life, increasing patient autonomy, and reducing cost to health care systems. In a multidisciplinary team setting, patients interact with nephrologists, nurses, and allied health staff, all of whom may influence a patient's modality choice. Our objective was to evaluate the perceptions of all renal team members toward home dialysis therapies. We performed a cross-sectional survey of multidisciplinary renal team members across five renal programs in British Columbia, Canada. The survey contained questions regarding primary work area, modality preference, patient and system factors that may influence modality candidacy, perceived knowledge of home therapies, and need for further education. A total of 334 respondents (22 nephrologists, 172 hemodialysis nurses, 49 home nurses, 20 predialysis nurses, and 71 allied health staff) were included (48% response rate). All respondents felt that home dialysis was beneficial for patients who work or study, improved patients' quality of life, and provided cost savings to the system. Compared with in-center hemodialysis nurses, home therapies nurses were between five and nine times more likely to favor a home therapy for patients of older age, lower socioeconomic status, lower educational level, higher burden of comorbidities, and those lacking social supports. Nephrologists and patients were felt to have the most influence on modality choice, whereas dialysis nurses were seen as having the least effect on modality choice. Most respondents felt the need for further education in home therapies. The majority of multidisciplinary team members, including allied health staff, acknowledged the benefits of home therapies. There were significant discrepancies among team members regarding patient-/system-level factors that may affect the candidacy of home therapies. Structured, focused, and repeated education sessions for all renal team members may help to address misperceptions around factors that influence modality candidacy.

Compassion fatigue among haemodialysis nurses in public and private hospitals in China.

This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics. A descriptive study was conducted using a self-designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018. The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant. Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals.

Factors Affecting The Satisfaction Of Hemodialysis Patients From The Nursing Care Received

Introduction: In the field of hemodialysis care, the issue of patient satisfaction is of particular importance. These patients are users of health care, usually for a long time. Most of them are particularly sensitive to the attitude of the health care system towards them. This requires special attention, especially when it comes to their opinion about the quality of the service they receive. Objective: To study and analyze the factors influencing the satisfaction with the received nursing care in patients on hemodialysis treatment. Material and methods: Documentary, sociological and statistical methods were used in the study. An anonymous survey surveyed the opinion of 575 patients on hemodialysis treatment in dialysis structures located in 8 cities (Varna, Ruse, Dobrich, Burgas, Shumen, Razgrad, Targovishte and Silistra). The data was processed using SPSS Statistics. Results: Examining patient satisfaction as users of hemodialysis nurses, we found that almost all were satisfied (90%). 8.52% of the respondents cannot assess their degree of satisfaction, and 1.74% of the respondents are completely dissatisfied. It is noteworthy that those who expressed dissatisfaction with nursing care are only males. As the age of the patients increases, so does the satisfaction with the care provided by the dialysis nurse. As the time spent on hemodialysis treatment increases, so does the satisfaction of patients with the nursing care provided. Patients with lower levels of satisfaction are more adamant that the nurse can contribute to the quality of dialysis care. Conclusions: Patients on hemocial treatment were satisfied with the care they received during treatment (p<0.001). Among the factors influencing their satisfaction are: gender (p <0.05), age (p<0.001), duration of hemodialysis treatment (p<0.05). Our study found that patients who felt that the nurse could influence the quality of care provided had a lower level of satisfaction.

The development of the Western Australian Haemodialysis Vascular Access Complexity instrument.

BackgroundThe Western Australian Haemodialysis Vascular Access Classification instrument was developed to classify the cannulation complexity of the arteriovenous fistula or arteriovenous graft as simple, challenging, or complex. Although the instrument was developed by experts in haemodialysis nursing, the instrument had not undergone formal validity or reliability testing.ObjectivesEvaluate the Western Australian Haemodialysis Vascular Access Classification instrument for content validity, interrater and test–retest reliability.DesignProspective cohort study.ParticipantsContent validity was assessed by haemodialysis nursing experts (n = 8). The reliability testing occurred in one in‐centre and one satellite haemodialysis unit in Western Australia from September to November 2019. Reliability testing was performed by 38 haemodialysis nurses in 67 patients receiving haemodialysis and 247 episodes of cannulation.MeasurementsInterrater and test–retest reliability assessment was conducted using κ, adjusted κ, Bland–Altman plots, intraclass correlation coefficient and Pearson's correlation coefficient.ResultsThe final version of the instrument (n = 20 items) had individual item‐level content validity indices ranging from 0.625 to 1.00 with a scale‐level content validity index of 0.89. For both interrater (n = 172 pairs) and test–retest (n = 101 pairs), most individual variables had excellent adjusted κ (n = 33 variables), some fair to good agreement (n = 6 variables) and one variable with poor agreement. The classification of simple, challenging and complex demonstrated adjusted κ of fair to good, to excellent agreement for interrater reliability with lower levels of agreement for test–retest reliability.ConclusionsThis instrument may be used to match a competency‐assessed nurse to perform the cannulation thereby minimising the risk of missed cannulation and trauma.

Hemodiyaliz Hemşirelerinde Merhamet Düzeyi ve İlişkili Faktörler

Amaç: Araştırma, hemodiyaliz hemşirelerinin merhamet düzeyini ve ilişkili faktörleri belirlemek amacıyla yapıldı. Materyal ve Metot: Tanımlayıcı ve ilişki arayıcı türde yapılan bu çalışmanın evreni Konya il merkezinde yer alan üniversite hastaneleri, Sağlık Bakanlığına bağlı hastaneler ve özel diyaliz merkezlerinde çalışan hemodiyaliz hemşirelerinden (n=90) oluşmakta olup çalışmanın yürütüldüğü tarihlerde kurumda olan ve çalışmaya katılmayı kabul eden hemodiyaliz hemşireleri (n=85) çalışma grubunu oluşturdu. Verilerin toplanmasında kişisel bilgi formu ve Merhamet Ölçeği (MÖ) kullanıldı. Verilerin değerlendirilmesinde; Mann-Whitney U Testi ve Kruskal Wallis H Testi kullanıldı. Bulgular: Hemodiyaliz hemşirelerinin yaş ortalaması 33.44±7.3 (21-48) olup; %81.2’si kadın, %76.5’i evlidir. Hemodiyaliz hemşirelerinin merhamet puan ortalaması 72.87±8.27 olup, sevecenlik alt boyutu puan ortalaması ile çocuk sayısı ve meslekte çalışma yılı arasında istatistiksel açıdan anlamlı bir fark olduğu (p<0.05) ve bilinçli farkındalık alt boyutu puan ortalaması ile hemşirenin diyaliz biriminde çalışma yılı arasında istatistiksel açıdan anlamlı bir fark olduğu görülmüştür (p<0.05). Sonuç: Araştırma sonucunda hemodiyaliz hemşirelerinin merhamet puan ortalamasının orta düzeyde olduğu ve sevecenlik alt boyutu puan ortalamasının çocuk sayısı ve meslekte çalışma yılı değişkenleri açısından; bilinçli farkındalık puan ortalamasının da diyaliz biriminde çalışma yılı değişkeni açısından farklılık gösterdiği belirlenmiştir.

MO882PATIENTS' UNDERSTANDING AND EXPERIENCE OF COVID-19 PANDEMIC AMONGST IN-CENTRE HAEMODIALYSIS POPULATION IN A SINGLE UK CENTRE

Background and AimsPatients with end-stage kidney disease on dialysis are susceptible to severe COVID-19 infections. However, during the pandemic, many renal patients were unable to ‘shield’ fully due to the ongoing need to attend the dialysis unit for treatment. With a significant proportion of our haemodialysis population coming from socially deprived and ethnic minority background (38%), we aimed to explore patients’ understanding and experience of COVID-19 pandemic.MethodThis was a cross-sectional survey of patients receiving in-centre haemodialysis from one centre in England conducted during July 2020, three months after the first UK national lockdown. The questionnaire consisted of 18 questions exploring patients’ awareness of COVID-19 pandemic, understanding of ‘shielding’, use of face covering, and their experience of haemodialysis treatment as well as accessing healthcare during COVID-19 pandemic. Those with language barriers were offered assistance and verbal translation by haemodialysis nurses, if possible, to complete the questionnaire.ResultsIn total, 232 patients (of a total of 479 in-centre dialysis patients, 48% response rate) completed and returned the questionnaire. Of these, 29 (12.5%) patients required help with the questionnaire due to language barrier. Mean age was 62 (SD 16) years, 63% were male, 53% were from ethnic minorities and 45% were from the most deprived area (MDI Decile 1). A third of the respondents lived with 3 or more adults at home and a quarter lived with one or more child.Majority of the patients (97%) were aware of COVID-19 pandemic, and most received information on COVID-19 from the news (87%). Dialysis staff (43.1%), family and friends (32.6%), internet (31%) and general practitioners (20.3%) were also key sources of information. Despite this, 17.2% of the patients did not know about ‘shielding’. Even though 3 in 4 patients stated that they were ‘always’ or ‘often’ able to ‘shield’, when prompted with scenarios, significant number of patients in fact felt that they were unable to shield when travelling to dialysis (56%), during dialysis (35%) or when shopping (17%). Majority of the patients (89%) said that they wore face covering and 28% self-isolated from the rest of household during the first peak of pandemic. 83% practised ‘social distancing’ at dialysis units but 5% did not and 6% felt unable to do so. Almost a quarter of the patients (23%, 54 patients) felt unwell during the first wave of COVID-19. Majority (50%) of them sought medical help by informing the dialysis unit, whilst 26% contacted their GP and 38% attended emergency departments. Of these 54 patients, 35% had difficulties accessing medical help, especially from primary care. One in four patients felt that their dialysis experience had changed during the pandemic: 10% increased use of private taxis or used different travel services, 3.5% reported increased travel time, 8% dialysed at a different unit, 5% experienced longer waiting time to start dialysis sessions and 4% had dialysis frequency reduced . Almost a third (29%) of the patients knew of someone in the dialysis unit who had COVID-19 infection during the first wave of pandemic.ConclusionCOVID-19 posed significant challenges for patients receiving in-centre haemodialysis. Despite their high susceptibility to severe COVID infection, significant number of patients was not aware of ‘shielding’ or able to ‘shield’ effectively. Some also experienced difficulties accessing medical help and a quarter reported change of transport or dialysis arrangement during the pandemic.

Assessment of Nurse’s Knowledge and Practices about Personal Protective Equipment in Hemodialysis Unit in Basra Teaching Hospital

Objectives: to assess the nurses’ knowledge and practices about personal protective equipment (PPE).Methodology: A descriptive cross-sectional design study has been carried out in Basrah teaching hospital,A purposive (non-probability) sample consist of (34) nurses who worked in the units of hemodialysis, thestudy started from 18th of October, 2019 to 12th of July, 2020. The instrument of the present study containsthree parts, first part: It is concerned with the nurse’s demographic data, second part: it is composed of (10)multiple choice questions (MCQs) related to the nurses knowledge, and third part: it consists of (14) itemsfor nurses practice about personal protective equipment. The validity of the instrument had been achieved by8 experts from different scientific branches. Statistical programs such as SPSS (Statistical Package for SocialScience) v. 23 were used to analyze the data. Result: the findings revealed that majority of nurses had poorknowledge and practice about personal protective equipment and there has been a significant relationshipbetween the nurse’s knowledge about personal protective equipment and their level of education at a p<0.05level. Recommendation: Provide training programs for the hemodialysis nurses on the promotion of higherstandards of the hand hygiene and potential uses of the personal protective equipment during working inhemodialysis centers.

POS-662 5-YEAR SURVIVAL RATE OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN END-STAGE RENAL DISEASE IN INDONESIA: CAN CAPD BE SOLUTION FOR ESRD IN LOW INCOME DEVELOPING COUNTRY?

There are an increase in End-Stage Renal Disease (ESRD) patients in developing countries every year, including Indonesia. Based on the 2018 Indonesian Basic Health Research, 3.8 ‰ of the Indonesian population is ESRD patient. The number of available hemodialysis machines and hemodialysis nurses in Indonesia is far from optimal, and the number of procedures and success rate of kidney transplants is still very low. Considering those limitations, Continuous Ambulatory Peritoneal Dialysis (CAPD) therapy is chosen as an option for renal replacement therapy in Indonesia. This study is aimed to report the 5-year survival of ESRD patients undergoing CAPD therapy in low income developing countries such as Indonesia. A retrospective cohort study was conducted involving 674 ESRD patients undergoing CAPD therapy. Data was taken from medical records from Malang CAPD Center of Saiful Anwar Hospital from August 2014 to July 2020. The 5-year survival rate and hazard ratio were analyzed using Kaplan-Meier and cox-regression analysis, respectively. 674 ESRD patients undergoing CAPD, 63.2% of patients survived up to 5 years with a general survival rate at 1, 3, and 5 years of 80%, 60%, and 52%, respectively. The 3-year survival rate of CAPD therapy in ESRD patients with comorbid hypertension and type II diabetes mellitus was 80% and 10%, respectively. The hazard ratio of ESRD patients on CAPD therapy with comorbid type II diabetes mellitus was 8.4 times (95% CI = 6.36-11.21). The 5-year survival rate of ESRD patients with CAPD therapy in Indonesia was good. Patients with comorbid type II diabetes mellitus had a worse survival rate. With all the problems of hemodialysis and kidney transplantation that exist in low income developing countries, CAPD can be a solution for renal replacement therapy.

Nurses competence and hemodialysis adequacy achievement

Competence is defined as a combination of an individual's knowledge, attitude, and skills. Nurses, as the primary caregivers to hemodialysis patients, have an essential role in achieving hemodialysis adequacy. Hemodialysis adequacy achievement is one of the quality indicators of hemodialysis care. The research aims to identify the relationship between nurse competence and the achievement of hemodialysis in Bandung. The research design was correlation analytical with a cross-sectional method, which involved 82 hemodialysis nurses and 82 hemodialysis patients. Samples were using consecutive sampling. The data were analyzed using chi-square. The result shows that nurse's competence, especially nurse's attitude and skills in providing nursing care for hemodialysis patients, has a significant relationship with the achievement of hemodialysis adequacy. Nurses in the hemodialysis unit should improve their knowledge, attitude, and skills in providing nursing care.

POS-823 SCRUTINY OF A WHATSAPP BASED CONTINUING NURSING EDUCATION TO FACILITATE ON THE JOB LEARNING AMONG HEMODIALYSIS NURSES

Smart phone users across East Africa use WhatsApp messaging as a common internet-based communication tool. Medical communities have reported successful continuing nursing educational (CNE) initiatives via this messaging platform. A Continuous Nursing Education(CNE) channel was provided on a single WhatsApp group to the hemodialysis nurses of Africa Healthcare Network into Rwanda and Tanzania since January 2019. This channel provided for informal learning via group chats, enabling the sharing of large data files (e.g.

Hemodialysis nurse burnout in 31 provinces in mainland China: A cross-sectional survey.

Job burnout is an occupational psychological syndrome with a high prevalence among nurses in China. Hemodialysis (HD) nursing work has the characteristics of high intensity, high technical content, and high risk. The aims of this study were to investigate the prevalence and level of job burnout among HD nurses in China and explore the potential factors associated with burnout among HD nurses. This was a cross-sectional study in 2019. Survey data were collected from 2738 HD centers in mainland China. Job burnout was measured by the Chinese version of the Maslach Burnout Inventory. The working atmosphere, interpersonal relationships with colleagues, and intention to leave were each assessed by a single question respectively. Multiple linear regression and structural equation modeling were used for the analysis. A total of 10,570 surveys were collected. A total of 1199 (11.34%) HD nurses reported a high level of emotional exhaustion, 782 (7.40%) reported a high level of depersonalization, and 6767 (64.02%) reported a low level of personal accomplishment. Job burnout in the Northeastern region of mainland China was higher than that in other regions (p < 0.05). The working atmosphere, interpersonal relationships, region, hospital level, educational level, career planning, age, and number of children were significantly associated with burnout among HD nurses (p < 0.001, adjusted R2 = 0.313). The working environment, individual factors, and specialist nurse training were significantly associated with HD nurse burnout and intention to leave (comparative fit index = 0.907; goodness of fit index = 0.930; root mean square error of approximation = 0.055). There were notable regional differences in the burnout of HD nurses. This study contributes to the knowledge of the possible relationship of job burnout and intention to leave in HD nurses. It is suggested that improving the working atmosphere or interpersonal relationships and providing more training opportunities can alleviate job burnout in HD nurses.