Renal Nurses Research Articles

Beyond Index Conditions: Applying a Multimorbidity Approach to Renal Cancer Nursing

ObjectiveThis article aims to describe the key components of renal cancer nursing and multimorbidity nursing, and reflects on how adopting a multimorbidity approach to renal cancer nursing can help nurses provide holistic patient care. MethodsThis is a discussion paper drawing on relevant evidence and theory. ResultsRenal cancer nurses have a highly specialised knowledge base and are able to use this expertise to deliver excellent care to people with cancer. However, lots of people with cancer have other conditions as well. Adopting a multimorbidity approach to nursing care provides a more holistic framework for care delivery. ConclusionsCancer nurses are ideally placed to support patients in this way, so they are able to deliver care which accounts for factors such as treatment burden and how this impacts on patients and carers. Implications for nursing practiceNurses who care for people with renal cancer should view their patients through the lens of multimorbidity. This involves screening for other chronic conditions, considering polypharmacy, providing emotional support and continuity of care, and coordinating care in a way that accounts for the potentially burdensome nature of the patient's interactions with health care.

Understanding nurses' perceptions of sexual health and function in people requiring haemodialysis.

Sexual dysfunction is common for adults receiving chronic haemodialysis; however, renal nurses seldom discuss this topic with patients. This study aimed to identify renal nurses' attitudes towards providing sexual healthcare and to determine their confidence in discussing sexual dysfunction with adults who are receiving haemodialysis. An online cross-sectional study. Renal nurses across Australia and New Zealand (n = 65) who were members of the Renal Society of Australasia provided direct care to adults receiving haemodialysis. Two questionnaires measuring (1) the frequency of sexual health discussions, levels of knowledge and competence, barriers to discussing sexual dysfunction and views on accountability (Van Ek survey) and (2) communication, practical knowledge, and attitude (sexual health educator for professionals scale) were used. Demographic characteristics were also collected. Most participants were females (60%) with postgraduate qualifications (61.4%). The average nephrology nursing experience was 13.10 ± 9.14 years. Most renal nurses identified as having positive attitudes (77.2%) about providing sexual healthcare and were confident in communicating with patients about sexual concerns (42.9%), although many nurses (64.35%) rarely did so. Less than one-half (48.6%) indicated feeling competent to discuss sexual dysfunction, and less than one-third (30%) had sufficient knowledge about sexual dysfunction. Barriers were lack of practical training (74.2%)and insufficient time (57.1%). Younger nurses (≤45 years old) and male nurses were significantly more confident in discussing sexual health matters. Overall, renal nurses had positive attitudes towards discussing sexual health concerns with patientshoweverthey rarely did so.

WCN24-1353 A journey of an Argentinian Nephrologist to an Australian Renal Nurse Practitioner

WCN24-1353 A journey of an Argentinian Nephrologist to an Australian Renal Nurse Practitioner

Effectiveness of Multidisciplinary Post-Acute Kidney Injury Clinic on Awareness and Knowledge in Acute Kidney Injury Survivors

Introduction: Acute kidney injury (AKI) awareness and knowledge among survivors is poor, leading to suboptimal self-management and follow-up care. The purpose of the study was to evaluate the impact of a multidisciplinary post-AKI clinic on AKI awareness and knowledge among survivors. Methods: We conducted a quasi-experimental study among stage 2-3 AKI survivors who were followed in the multidisciplinary post-AKI clinic, comprising nephrologists, renal nurses, pharmacists, and dietitians. Patients were evaluated before and after entering the clinic during a 3-month follow-up period, using a three-component questionnaire including the following: (1) Do you know of your AKI diagnosis during hospitalization? (yes/no), (2) how do you rate your AKI knowledge? (ranging from 1 or “very low” to 5 or “excellent”), and (3) 25-item objective AKI knowledge survey instrument that covered general knowledge of AKI, nutrition, medication, and symptoms of renal failure. Results: A total of 108 AKI survivors were enrolled, with 37.0%, 41.7%, and 21.3% being stage 2 AKI, stage 3 AKI, and stage 3-dialysis AKI, respectively. Before entering the clinic, 50% of patients were unaware of their AKI during hospitalization. After receiving education from the multidisciplinary post-AKI clinic, all patients became aware they had experienced AKI. The mean perceived knowledge and objective knowledge scores were significantly increased over the 3-month period from 1.6 (0.7) to 3.9 (0.7) out of 5 and 15.4 (3.5) to 21.4 (2.0) out of 25, respectively (p < 0.001 for both). Additionally, reverse transformation of the Likert scale to a percentage format also revealed a significant improvement in mean perceived AKI knowledge scores, transitioning from 13.8 ± 16.8 to 73.0 ± 17.6, p < 0.001. Conclusion: The multidisciplinary post-AKI clinic effectively enhanced AKI awareness and knowledge among survivors. These findings highlight the importance of follow-up care and the benefits of a multidisciplinary approach. Further studies are needed to determine the long-term outcomes associated with increased knowledge.

Understanding the research agenda within renal nursing: an ANNUK project

Journal of Kidney CareVol. 8, No. 2 Society UpdateUnderstanding the research agenda within renal nursing: an ANNUK projectSarah BrandSarah BrandEmail: E-mail Address: [email protected]Assistant Divisional Nurse, CAS; Senior Research Nurse, Renal and Transplant UnitSearch for more papers by this authorSarah BrandPublished Online:21 Mar 2023https://doi.org/10.12968/jokc.2023.8.2.91AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References AbuRuz ME, Hayeah HA, Al-Dweik G, Al-Akash HY. Knowledge, attitudes, and practice about evidence-based practice: a Jordanian study. Health Science Journal. 2017;11(2):1. https://doi.org/10.21767/1791-809X.1000489 Google ScholarEmpranza JL, Cabello JB, Burls AJ. Does evidence-based practice improve patient outcomes? An analysis of a natural experiment in a Spanish hospital. J Eval Clin Pract. 2015;21(6):1059–1065. https://doi.org/10.1111/jep.12460 Google ScholarMelnyk BM, Fineout-Overhold E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: igniting a spirit of inquiry. Am J Nurse. 2009;109(11):49–52. https://doi.org/10.1097/01/NAJ.0000363354.53883.58 Google ScholarMelnyk BM, Fineout-Overhold E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: the seven steps of evidence-based practice. Am J Nurse. 2010;110(1):51–53. https://doi.org/10.1097/01.NAJ.0000366056.06605.d2 Google ScholarPowers J. Increasing capacity for nursing research in magnet-designated organizations to promote nursing research. Appl Nurs Res. 2020;55(1):1–6. https://doi.org/10.1016/j.apnr.2020.151286 Google ScholarSmyth A, Carter V, Dube A, Cannaby AM. How a better understanding of nursing research roles may help to embed research into clinical structures. Br J Nurs. 2022;31(17):1–7. https://doi.org/10.12968/bjon.2022.31.17.902 Google ScholarStraus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: how to practice and teach it. Edinburgh: Churchill Livingstone Elsevier; 2011 Google Scholar FiguresReferencesRelatedDetails 2 March 2023Volume 8Issue 2ISSN (print): 2397-9534ISSN (online): 2397-9542 Metrics History Published online 21 March 2023 Published in print 2 March 2023 Information© MA Healthcare LimitedKeywordssupportcollaborative workingspeacial interest groupsspecialist nursesPDF download

Retracted: Research on the Application Effect of Strengthening Risk Management in Continuous Renal Replacement Therapy Nursing of Critically Ill Patients.

[This retracts the article DOI: 10.1155/2022/2363877.].

Assessment of Nurse’s Knowledge Regarding Postoperative Renal Surgery Complication in El Gazira Hospital for Renal Surgery and Disease

Background: Nurses play an important role in post operative patient care, including close observation, problem assessment, and complication monitoring.&#x0D; Aim: This study was aimed to assess nurses Knowledge regarding postoperative renal surgery complication.&#x0D; Methods: This is a descriptive hospital-based study, conducted in the Kidney Center at El-Jazira Hospital during the period from October 2016 to April 2019. The study was involved 35 staff nurses as total coverage. Self-administrated questionnaire was used to interview the study population. The nurse’s knowledge was assessed by using scoring system in which the data was distributed into three categories to measure the level of nurse’s knowledge about Post Renal Complication (PRC), if the nurse respond to (4, 3) choice it was consider as good knowledge, (2) choice consider as fair knowledge, while (1, 0) choice was consider as poor knowledge. Each nurse was given one week to fill the questionnaire and return it. The collected data was analyzed using statistical package for social sciences (SPSS version 21) and presented in forms of tables and figures.&#x0D; Results: The questionnaire was completed by all involved nurses. The overall knowledge of post-enal surgical complications is 90.01 %. More than 91.4 % are well-versed in the various types of kidney rejection. The majority of nurses have good knowledge about the nursing role in postoperative renal transplantation. More than 94.3 % of nurses have good knowledge about home nursing for renal transplant patients. More than 94.4 % of Nurses have good knowledgeable about post-operative renal stone nursing. The knowledge of the involved nurses about prostate surgery was ranged 94.3% to 100% and about radical nephrectomy was 85.7% to 100%. Nurse’s knowledge about partial nephrectomy surgery is ranged from 80.0% to 100%.&#x0D; Conclusions: The study concluded that there was adequate knowledge of nurse’s staff regarding postoperative care for patients with postoperative renal surgery complications.

HFRenDs: an inaugural conference of heart failure, renal and diabetes specialist nurses

Journal of Kidney CareVol. 7, No. 6 Association of Nephrology NurseshFRenDs: an inaugural conference of heart failure, renal and diabetes specialist nursesMarissa DaintonMarissa DaintonEmail: E-mail Address: [email protected]Education Committee Member, Association of Nephrology Nurses UKSearch for more papers by this authorMarissa DaintonPublished Online:22 Nov 2022https://doi.org/10.12968/jokc.2022.7.6.298AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Jankowski J, Floege J, Fliser D, Böhm M, Marx N. Cardiovascular disease in chronic kidney disease. Circulation. 2021; 143(11):1157–1172. https://doi.org/10.1161/circulationaha.120.050686 Google ScholarUK Renal Registry. 24th Annual report. 2022. https://ukkidney.org/audit-research/annual-report/24th-annual-report-data-31122020 (accessed 4 October 2022) Google Scholar FiguresReferencesRelatedDetails 2 November 2022Volume 7Issue 6ISSN (print): 2397-9534ISSN (online): 2397-9542 Metrics History Published online 22 November 2022 Published in print 2 November 2022 Information© MA Healthcare LimitedKeywordsheart failurerenaldiabetesspecialist nursesPDF download

Facilitating personal hygiene choices for renal patients with central venous lines: a multi-phase study

This study explored personal hygiene options of renal patients that maintain the integrity of central venous catheter exit site dressings between dialysis sessions. Background: Infection is a major life-limiting risk for patients undergoing haemodialysis via a central venous catheter. Meticulous attention to keeping the exit site dressings clean and dry is an essential defence in preventing local and systemic infections. It is difficult to maintain the integrity of water-resistant dressings in tropical environments. Study Design: A three-phase exploratory study was conducted in a northern Australian Renal Service. Methods: Phase 1 employed a cross-sectional, anonymous, online survey of renal nurses about the acceptability and feasibility of two hygiene options for patients: bathing wipes and a waterproof dressing cover. The survey also canvassed their concerns about the options. Descriptive statistics were used to summarise Likert-scale responses and content analysis was used for responses to open-ended survey questions. Phase 2 used conversational-style interviews with patients about their hygiene preferences, how they endeavoured to keep their dressings dry, and their impressions regarding the proposed options. Phase 3 was a series of case studies of patients trialling the provided options over a six-week period. Participants were progressively recruited to this phase and were provided with the product/s of their choice at each dialysis session; renal nurses also assessed the integrity of the dressings at each dialysis session. Research nurses discussed with the participants their experiences with the options. Results: Phase 1: Nurses (N=37, response rate 58.7%) considered both options acceptable and feasible for patients, noting some practical concerns related to their use. Phase 2: Patients (N=27, 100% participation rate) described hygiene preferences and difficulties they encountered with keeping dressings dry. Only one participant had a bath, as per written advice. All were enthusiastic about trying the proposed options. Phase 3: Patients (N=22) appreciated being able to shower without wetting their exit site dressings. Individuals were inventive in modifying the application and use of the waterproof cover according to their body shape and the central venous catheter exit site location. Although participants liked both options, the waterproof covering was most popular and most frequently used. Intactness of the dressings was 83% during the trial; there were no central venous catheter-associated infections during the study. Conclusion: Self-management and choice were motivating factors for participants. Patients embraced being able to keep their dressings dry and intact during personal hygiene in a tropical environment. Implications for research, policy, and practice: Patients demonstrated their willingness to undertake a more active role in their dressing care, while exercising choice with respect to personal hygiene. Studies that further increase patients’ participation in other aspects of their self-care warrant further investigation. The organisation is pursuing options for the ongoing provision of the products used in this study and how their use can be monitored in clinical practice. What is already known about the topic? Intact dressings provide an important line of defence against infection in the vulnerable population of patients receiving dialysis via central lines. Hygiene needs are also an important consideration for quality of life, empowerment, and autonomy. Patients’ current attempts to meet their own hygiene needs often result in a disruption to the intactness of the dressing site and predispose them to systemic infections. What this paper adds This study facilitated exploration of two feasible hygiene options in an open and culturally safe manner, from both patients’ and nurses’ perspectives. The opportunity to perform personal hygiene according to individual preferences resulted in a willingness of participants to undertake a more active role in the care of their dressing. The identification of two acceptable and feasible personal hygiene options has the potential of removing one of the many lifestyle modifications faced by people who undergo haemodialysis via a central venous catheter.

Research on the Application Effect of Strengthening Risk Management in Continuous Renal Replacement Therapy Nursing of Critically Ill Patients.

Objective To evaluate the efficacy of risk management in the nursing of critically ill patients on continuous renal replacement therapy (CRRT). Methods In this retrospective study, 80 critically ill patients on continuous renal replacement therapy in our hospital from February 2020 to February 2021 were recruited. They were randomly assigned to receive either the risk management treatment (risk management group) or the conventional management treatment (conventional management group) via the random number table method. Outcome measurements included the occurrence of adverse events, complications, psychological status, quality of life, treatment compliance, duration of CRRT, and nursing satisfaction. Results Risk management treatment was associated with lower incidence of adverse events compared to conventional management treatment (P value < 0.05). The risk management group also resulted in a lower incidence of complications compared to the conventional management group (P value < 0.05). Patients who received risk management treatments demonstrated a significantly lower anxiety/depression level and a higher World Health Organization Quality of Life Brief Version (WHOQOL-BREF) (P value < 0.05). The risk management group resulted in more cases with high compliance and fewer cases with moderate and poor compliance (P < 0.05). Risk management was associated with more cases with a CRRT duration less than 36 hours and 36–48 hours and fewer cases with a duration longer than 48 h (X2 = 2.999, P value < 0.05). Patients who were given a risk management treatment had a higher nursing satisfaction compared to conventional management treatment (X2 = 4.501, P value < 0.05). Conclusion Risk management treatment in caring of critically ill patients on CRRT shows better efficacy than conventional management treatments.

Views and practices of renal nurses in monitoring residual renal function for haemodialysis patients

BackgroundHaemodialysis is a treatment option offered to patients with end-stage kidney disease. Patients who commence haemodialysis will often have some degree of residual renal function (RRF) with a continued urine output between treatment schedules. Efforts to preserve the remaining RRF can offer several health benefits for haemodialysis patients. AimTo explore the views and practices of Australian and New Zealand renal nurses in monitoring RRF of haemodialysis patients between treatment schedules. MethodsThis study used a cross-sectional research design. Participants were recruited through distribution of an electronic survey. Quantitative descriptive data were analysed and presented as frequencies, percentages, medians, and interquartile ranges. Reporting of this study adhered to the STROBE checklist. FindingsFifty-five renal nurses completed the survey. Of these, 10 (18.2%) always, 41 (74.5%) sometimes, and 3 (5.5%) never discussed urine output with patients before commencing haemodialysis. Eight (14.5%) participants indicated ultrafiltration goals did not include calculations based on urine output between treatment schedules. DiscussionThe monitoring of RRF provides several health benefits for patients requiring maintenance haemodialysis. Practice differences in fluid assessment policies did not always account for self-reported urine output. The inclusion of an estimated daily urine output between treatment schedules has the potential to lower ultrafiltration goals minimising the risk of intradialytic hypotension. ConclusionThe survival and quality of life for patients requiring maintenance haemodialysis can be improved by the preservation of RRF. Findings from this study suggest practice differences occur among renal nurses in the monitoring of urine output.

MO1051: Standardized Simulation Education Program with Summative Assessment on Exchange Procedure of Ultrabag System for Peritoneal Dialysis: Innovations in Practical Recommendations

Abstract BACKGROUND AND AIMS Inexperience in practicing peritoneal dialysis (PD) and lack of standard education program under the instruction of qualified renal nurses are known causes of peritonitis in patients with chronic renal failure [1]. Thus far, the standardized and validated curriculum for Continuous Ambulatory Peritoneal Dialysis (CAPD) training has not been well-established under simulation-based education model [2]. We aimed i) to develop a well-structured and standardized educational training program on exchange procedure of Ultrabag system and ii) to evaluate the degree of acquisition in domains of cognitive (knowledge) and psychomotor (skills) by summative assessment using valid and reliable knowledge evaluation index and performance checklist. METHOD Following an invention of 3D-printed CAPD device, ‘Helping Hands’ in closed system operation, the Renal Unit in the Department of Medicine and Multi-Disciplinary Simulation and Skills Centre (MDSSC) in Queen Elizabeth Hospital (QEH) formulated a standard 5-day CAPD training to equip PD patients with knowledge and skills for safe Ultrabag exchange. In order to optimize training effectiveness and assessment standards, the program was designed with ‘6 (+2 additional) guiding questions’ from the International Society for Peritoneal Dialysis (ISPD) document [3]. Scoring Checklist with specific and relevant items, such as fixation of the connecting catheter, parallel point-to-point connection and procedures in placing disinfection cap, could strengthen internal validity. RESULTS In 2021, 17 CAPD patients with partial impairment in vision (12, 71%) or eye-hand coordination (13, 77%) attended this education program. Post-training assessment showed that participants had improved cognitive knowledge (M = 71%; A Grade (&amp;gt;80 marks) = 5, 29% B Grade (60–80 marks) = 9, 53%; C Grade (&amp;lt;60 marks) = 3, 18%) and psychomotor skills (100% achievement in simulation task). Except for 1 participant who required additional training session and re-assessment, 94% of them passed the simulation examination by completing all procedures without any assistance in one-take. A validated educator-guided scheme of psychomotor skills in proper use of CAPD is recommended with six operational phases: CONCLUSION Repetitive performance in task-specific procedure of bag exchange, coupled with constructive feedback from experienced renal nurse educators and well-validated assessment (with a standardized scoring sheet and checklist), resulted in improved skill performance. The training program, correspondent with traditional concept of Miller's pyramid (1990), demonstrated how CAPD novice turns skillful user by developing competence in cognition with factual knowledge of dialysis (‘Knows’) and verbalization of rationale and flows of PD (‘Knows How’); and competence in behavior with simulation practice with CAPD device (‘Shows’) and summative assessment demonstrating mastery of safe bag exchange skills to be integrated into everyday practice (‘Does’). Further studies may be warranted to investigate whether knowledge and skills acquired before use of CAPD could be carried over time and on how education program accounts for risk minimization of CAPD-related peritonitis and survival rate.

Renal Nurse of the Year Award 2022

Sarah Brand discusses the 2022 finalists for the Renal Nurse of the Year award

Diet in the management of non-dialysis dependent chronic kidney disease: perceptions and practices of health professionals

BackgroundTherapeutic strategies, including dietary intervention, to target non-dialysis dependent Chronic Kidney Disease (CKD) progression have been at the forefront of recent renal research. Nephrologists and other renal health professionals are key stakeholders in the dietary management of patients with non-dialysis dependent CKD and referrals to dietetic services. The aims of this study were to explore (i) health professional perceptions regarding the role of diet in managing non-dialysis dependent CKD, and (ii) health professional practices regarding the provision of dietary advice and referrals to dietetic services.MethodsA 31-item online survey was emailed to members of professional renal networks and associations in Australia and New Zealand. Data was analysed descriptively. Categorical variables were assessed to determine associations between referral frequency, demographic variables, health professional role (non-dietetic versus dietetic) and perceptions of the role of diet.ResultsOverall, 189 health professionals completed the survey. Nephrologists (42%), renal nurses (29%) and renal dietitians (24%) were the most common respondents. Non-dietetic health professionals rated the importance of diet in the management of non-dialysis dependent CKD significantly lower than renal dietitians (73% versus 98% ranked as very-extremely important, p = 0.002). Fifty percent of non-dietetic health professionals referred patients to renal dietetic services never or 0–25% of the time. Reasons for not referring included perceptions there is a lack of evidence that diet reduces CKD progression, perceptions that patients will not adhere to dietary recommendations, and a desire to reduce visit burden for patients. Barriers to accessing dietetic services were perceived to be significant and include lengthy wait times and inadequate dietetic staffing.ConclusionInconsistencies exist between non-dietetic health professionals and dietitians regarding the importance of diet in non-dialysis dependent CKD. Referral practices appear to be influenced by beliefs about the evidence base and perceptions regarding the ability of dietitians to meet referral demand. Raising awareness for non-dietetic health professionals working in nephrology regarding the evidence on diet and CKD progression is needed. An improved understanding of this evidence base may improve knowledge and referral patterns. Further, an increase in renal dietetic staffing is recommended to enhance patient access to services.

Peritoneal dialysis first policy in Hong Kong for 35 years: Global impact.

Peritoneal dialysis (PD) first policy has been established in Hong Kong since 1985. After 35 years of practice, the PD first policy in Hong Kong has influenced many countries around the world including governments, health ministries, nephrologists and renal nurses on the overall health policy structure and clinical practice in treating kidney failure patients using PD as an important dialysis modality. In 2021, the International Association of Chinese Nephrologists and the Hong Kong Society of Nephrology jointly held a symposium celebrating the 35 years of PD first policy in Hong Kong. In that symposium, experts and opinion leaders from around the world have shared their perspectives on how the PD first policy has grown and how it has affected PD and home dialysis practice globally. The advantages of PD during COVID-19 pandemic were highlighted and the use of telemedicine as an important adjunct was discussed in treating kidney failure patients to improve the overall quality of care. Barriers to PD and the need for sustainability of PD first policy were also emphasized. Overall, the knowledge awareness of PD as a home dialysis for patients, families, care providers and learners is a prerequisite for the success of PD first. A critical mass of PD regional hubs is needed for training and mentorship. Importantly, the alignment of policy and clinical goals are enablers of PD first program.

Mental Health Problems in Renal Nurses During Novel Coronavirus Disease of 2019 Pandemic

Mental Health Problems in Renal Nurses During Novel Coronavirus Disease of 2019 Pandemic

A role that has transformed the care of patients with acute kidney injury.

Anne Grace, Acute Kidney Injury Specialist Nurse, Walsall Healthcare NHS Trust (anne.grace@walsallhealthcare.nhs.uk), runner-up in the Renal Nurse of the Year category of the BJN Awards 2021.

Optimising health care for people living with chronic kidney disease: Health-professional perspectives.

People with chronic kidney disease are often multimorbid and have complex psychosocial needs. For health professionals to deliver holistic, person-centred care to individuals and their carers living with this multifaceted disease, they are required to communicate complex information and problem solve in a multifactorial health and disease context. To explore the perspectives and experiences of tertiary care multidisciplinary team members and primary care providers of health care to people with chronic kidney disease; identify opportunities to innovate and improve the coordinated delivery of health services. The qualitative study design used purposive sampling to recruit 39 health professionals, working in the primary and tertiary sector in a regional Australian health district. Participants included general practitioners, renal and general practice nurses, dietitians, nephrologists and social workers. The data were collected through semistructured interviews and analysed using a relativist ontological position and directed content analysis approach. Analysis of interviews was undertaken by three independent researchers and key themes were derived via consensus. A common goal to deliver person-centred individualised care was evident among health care professionals. However a deficit in shared understanding of the disease within and between disciplines was identified. The complex nature of chronic kidney disease requires up-skilling of health professionals to ensure patient education is targeted to individual health contexts and motivates self-management. Improved communication and comprehension might best be achieved across disciplines with an integrated approach to delivery of primary health care to individuals living with early-stage kidney disease.

Renal nurses' experiences of patients with severe mental health conditions receiving acute haemodialysis: A qualitative study.

Patients receiving acute haemodialysis treatment and living with severe mental illness may display behaviours that are perceived as challenging and stressful for renal nurses to manage in the acute haemodialysis unit. Renal nurses are historically trained on the technical aspects of acute haemodialysis and can provide a level of psychological support to patients. However, they have not been trained to manage patients with severe mental illness. To explore renal nurses' experiences of nursing patients with severe mental illness receiving acute haemodialysis, and to identify factors that facilitate or hinder the nursing care of these patients. A descriptive qualitative study. Purposive sampling was employed, and semi-structured interviews were conducted with 10 renal nurses working in an acute haemodialysis unit. Thematic analysis was utilised to analyse the data. Thematic analysis identified four main themes which are perspectives of mental Illness, patient and staff safety concerns, facilitators of care and education and support needs. Renal nurses experienced difficulty managing challenging behaviours manifested by patients with severe mental illness. Despite the various challenges, renal nurses adopted a person-centred approach. Staff shortages and lack of training were significant hindrances to care delivery. Education on mental health conditions, support from senior staff and collaborative working can enable confidence and increase renal nurses' knowledge and experience in mental health care.

Personal reflections of the contribution of research nurses and nurse researchers during the COVID-19 pandemic

Nicola Anderson, Chair of the Association of Nephrology Nurses' Nursing Research in Kidney Care Special Interest Group, shares the experiences of renal research nurses and nurse researchers during the COVID-19 pandemic