ANNA Transplant Special Interest Group session: posttransplant glucose management and donor exchange programs

Posttransplant glucose management and paired donor exchange programs are important topics that require additional focus and development. Nurses who work with patients receiving transplants need to become familiar with both in order to make the necessary changes in nursing practice.

[Expected benefits of a nursing consultation on the compliance of the adolescent renal transplantation patient]

Benefits expected from a nurse consultation on the therapeutic compliance of the student with a kidney transplant The therapeutic non-observance of chronic ill teenagers in general, and of teenagers who had a kidney transplant in particular, is a genuine problem of public health. At the children Hospital of Toulouse, from March 2002 to March 2003, a nurse consultation coupled with the medical consultation, was set up for the follow-up of these teenagers. The object of this research in nurse care was to appraise, at the end of a year's operation, the results of this consultation on the therapeutic observance of these teenagers and its operation within the institution. At the dawn of a deep upheaval for the profession, this study enabled us to valorise the nurse expertise combined with the medical activity for the actual benefit of children. The nurse consultation, in the heart of the news for some time, has remained in the heart of our concern for over half a century.

[Physical, psychological, social, and spiritual issues facing kidney transplant recipients]

Kidney Transplantation (KT) is one of the best treatments for patients with end-stage renal disease. The "new" organ starts functioning after transplantation, but this doesn't mean that the patient now lives without chronic illness. On the contrary, the patient is actually living with another chronic disease. KT not only keeps patients alive, but also encourages them to live their daily lives well, enjoying better psychological well-being and quality of life, and playing role functions and taking responsibilities based on their development tasks. But, KT patients encounter physical problems (infection, rejection, and long-term complications), psychological problems (social stresses, depression, low self-esteem, and altered family interaction), and unemployment issues. Nurses play an important role in assisting KT patients and should adopt appropriate interventions, education programs, and psychological counseling programs to help them to cope with their stresses. This article discusses the physical, psychological, spiritual, and social issues affecting KT patients and seeks to propose suggestions regarding future studies and KT care.

Continuing education in medicine: a useful tool for nurses' empowerment in renal transplantation

BACKGROUND

Continuing Education in Medicine (CEM) underlines the importance of updates and information for the health care team. Our aim was to describe the organization and results of a CEM course "educate to organ donation" that involved the nursing team in an educational experience with high school students. The course consists of theory (4 hours; the physician-patient relationship, the educational role of the nurse, the teaching policy, checklist, and results of a school education program) and practice (10 hours; the attendants join the teaching team in the classrooms and in the plenary session). Analysis of anonymous questionnaires performed after the course contained semistructured questions and analog scales.

RESULTS

The first acknowledgment came from the Cabinet of Public Health, which gave the maximum number of credits (14 for 14 education hours).

PARTICIPATION

presently 40 nurses, about 40% of those working in the renal unit (over 30 CEM courses are available in the hospital). Satisfaction: Overall score was median 8.5 (6 to 10) including teaching materials = 8 (4 to 10). Among the theoretical part, the lesson on patient-physician relationship obtained the highest score. The main drawback was the shortness of the practical part. The classroom meeting achieved a median score of 9.5 (7 to 10), the general session = 9 (5 to 10). All but one nurse registered for an "advanced" course, giving more time to the practical part (20 hours).

CONCLUSION

CEM may represent an important way to deliver education on transplant-related issues to patients and to the general population.

The postoperative care of the adult renal transplant recipient

Advances in transplantation immunology management have contributed to more frequent transplants and better long-term graft survival. Nurses must consider many issues facing the transplant recipient such as medication management, infection prevention, chronic disease management, fluid balance, urine output, and the many psychological issues that surround receiving a transplant. Important guidelines of care of complex transplant patients in the postoperative period are provided.

Challenges for nephrology nurses in the management of children with chronic kidney disease

An important treatment goal for pediatric nephrology caregivers is the optimization of a child's capacity for normal growth and development. However, the physiologic and metabolic derangements associated with chronic kidney disease (CKD) significantly alter these processes, creating important challenges in the care of affected children. Evidence-based clinical practice guidelines support early recognition and treatment of CKD-related complications to improve growth and development and, ultimately, quality of life for children with this chronic condition.

The Research Board of the European Dialysis and Transplantation Nurses Association/European Renal Care Association (EDTNA/ERCA)

The Research Board (RB) of EDTNA/ERCA is a multidisciplinary group, established by the participation of renal care centres all around Europe. The RB also works with the association's Special Interest Groups (SIGs) on developing guidelines for implementing safe renal clinical practice. It is composed of six permanent members, with co-opted experts from specific fields. This article describes how the RB works and the projects implemented since 1996.

The NSF for Renal Services. Part One: Dialysis and transplantation

Part one of the National Service Framework for Renal Services--focusing on dialysis and transplantation--has recently been published. It sets five standards and aims to help the NHS and its partners manage demand, increase fairness of access and improve choice and quality in dialysis and kidney transplant services.

Medication-taking beliefs of adult renal transplant recipients

PURPOSE

To describe the medication-taking beliefs of younger and older adult renal transplant recipients.

METHOD

A descriptive design was used to study 16 adult renal transplant recipients, 8 older and 8 younger, recruited from a renal transplant program in the midwest. A semistructured interview was conducted based on the theory of planned behavior. Data were examined using manifest content analyses.

RESULTS

Both groups had similar behavioral, normative, control, and problem-solving medication-taking beliefs. Planning ahead, organizing, using cues, involving a support person, and remembering the donor and life on dialysis were key control beliefs. Differences were found in beliefs regarding difficulties with taking immunosuppressive medications. The majority in both groups mentioned forgetting to take their immunosuppressive medications on at least one occasion. CONCLUSIONS/APPLICATION: As empiric evidence in this area grows, the clinical nurse specialist is paramount in assisting both younger and older renal transplant recipients with immunosuppressive medication taking and, consequently, in fostering better outcomes.

What is new with renal transplantation?

Dialysis and transplantation bring new hope and life to thousands of patients with end-stage renal disease. Renal transplantation restores reasonably normal health to patients whose kidneys no longer function and frees them from the limitations imposed by dialysis. Improved graft survival rates have further enhanced the desirability of transplantation. Currently in the United States, more than 80,000 people are living with a functioning renal transplant. The introduction of laparoscopic and laparoscopy-assisted techniques has proven to be a major improvement to living donation. This less invasive method of donating a kidney has more than doubled the chance that a patient with kidney failure will receive a transplant from a friend or loved one. New immunosuppressant medications, improved success rates, and the proliferation of transplantation centers have made renal transplantation a viable choice for many patients. The future will be dependent upon a marked increase in organ donation, which in turn will bring about earlier transplantation for patients with end-stage organ failure.

The postanesthesia care of an adult renal transplant recipient

Renal transplantation is the most common type of solid organ transplant performed in this country. For the PACU nurse, the immediate postoperative care of a renal transplant recipient can present a very unique and interesting challenge. Like all patients arriving to the PACU, the initial assessment of an immediate postoperative renal transplant recipient should first address the routine postsurgical concerns of airway, respiration, and hemodynamics. Most renal transplant programs have set protocols for the care required during the immediate posttransplant stay in the PACU. The postanesthesia nurse caring for these patients must become knowledgeable of these protocols. The following is a review of the immediate postanesthesia care for both the "fresh" renal transplant and the care of the long-term renal transplant recipient who has had surgery.