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I work for an organization that the Nephrologist admit patients to initiate Hemodialysis. They are the only group of Nephrologist in town. I can't find any best practice to say initiating in the hospital or outpatient clinic is best. The organization that I wourl for has a 36 bed Nephrology Unit in it. Any information would greatly be appreciated.
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I would like to learn if any out-patient dialysis centers are doing individualized machine temp. setting based on each patient's body temp. Also, please comment on if this practice has increased reports on machine programming error. Your comment is very appreciated. Thanks
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We have our next meeting scheduled for September 27th at well bound Memphis with Brenda Warren on Velphoro the address is 780 Truse Parkway ,the meeting will start at 6:00 pm,Put this on your calendar would like to see you there. Kathy Austin President of local chapte
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I am a nurse in a 28 chair dialysis clinic, and our doctors are implementing the new rule of removing no more than 13mL/kg/hr. I have read the NNJ article on this issue and how pulling more than this amount causes myocardial stunning. My question is concerning the exact calculation. The current calculation we are using is “Estimated Dry Weight X 13 X Treatment hours”, then this number is used as the patient’s max. What this formula does not take into account is prime, flushes, or the patient’s pre-treatment weight. What I thought was more appropriate is “(Pre-Treatment weight X 13 X Treatment hours) + prime and/or flushes”. Can anyone ...
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High Burden, Great Opportunity: Preventing Heart Attacks and Strokes = Free Continuing Education (http://emergency.cdc.gov/coca/continuingeducation.asp) Date: Tuesday, February 23, 2016 Time: 2:00 - 3:00 pm (Eastern Time) Participate by Phone: 800-857-9697 (U.S. Callers) 212-287-1833 (International Callers) Passcode: 4396514 Participate by Webinar: https://www.mymeetings.com/nc/join.php?i=PW6927490&p=4396514&t=c Presenter(s) Janet S. Wright, MD, FACC Executive Director Million Hearts® U.S. Department of Health and Human Services ...
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CDC Interventions show sustained success for outpatient hemodialysis infection prevention Dear Colleagues: A new CDC study shows that decreases to certain bloodstream infection (BSI) rates can be maintained through the use and implementation of CDC dialysis BSI prevention tools. The new study reported a 44% drop in access-related bloodstream infections (ARBSI) and estimated more than 60% of expected ARBSIs may have been prevented over the four year period among dialysis patients treated at facilities using the CDC’s Core Interventions for Dialysis BSI Prevention as part of a collaborative project. ...
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G.K. Chesterton said: "It isn't that they can't see the solution. It's that they can't see the problem". 80% of patient errors in health care services result from negative conflict and poor communication. Employee conflict happens in every workplace. Conflict becomes negative when differences are handled poorly (and this sometimes is without management knowledge). Are there models of conflict resolution out there that have evidence of improved outcomes (less conflict and safer environment)? What are some of your ideas on reducing conflict? All responses appreciated
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If you have a PD patient admitted to the hospital who completes the PD treatments? Do you have an assigned team of nurses? Is the patient and family responsible
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In our Dialysis Unit the Dialysis Technicians are now being allowed to handle patients with dialysis catheter and administer medication. Shockingly they are now writing Nursing Care Plan in the documentation. What can you say about this? Are they allowed of this practice? As far as my knowledge is concern what they are doing is Malpractice. It is beyond their scope of practice. Our Unit is JCI accredited and yet the safety of the patient is at risk in my opinion by allowing this practice of the HD Technicians. How can they write Nursing Diagnosis if they are not nurses? Who will be held liable for this act if there is any accountability?
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Applying to the Commissioned Corps The Commissioned Corps will open the application process for the following career fields on the dates listed. This process is open for highly qualified applicants willing to serve in the Bureau of Prisons, and/or the Indian Health Service. Please see specific requirements for qualified applicants and job openings by following the links below: On December 15 th and 16 th the general duty application process will open for BSN/MSN nurses candidates. The first 40 qualified candidates will move forward with the process. There are still opportunities for nurse practitioners ...
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See the original Discussion Po
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Good Evening, The Hazel Taylor Chapter (239) is requesting calls for nominations for 2015-2016 chapter officers. We have open positions for Chapter President Elect and Secretary. These positions are both 2 year conmittments. If you know of someone that is interested in running for one of these positions please notify any of the current chapter officers. Patricia Patterson- President Angie Kurosaka-President Elect Barbara Odum-Secretary Sara Kennedy- Treasure
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We have an adult PD population of close to 100 pts. All use the Fresenius cycler. One pt is using the Baxter at their preference. The Fresenius cycler is quite easy to use and the training materials are easy to understand. The pin technology at the end of the treatment adds additional protection from contamination. We generally train for 2 to 3 days after the patient has been performing CAPD for about a month. We do the PET and train first day using a fake belly. We use the fill amounts that the pt will be using so we have a good idea of the actual time it will take them to fill and drain to help the doctor with ordering the proper times to avoid ...
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We utilize LVN's in our chronic HD unit but not currently in PD. I suggest checking with your state LPN board to clarify their scope of practice. Each state is different.
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I am reaching out to see what others acute units are budgeted for hours per patient day and how productivity is measured in your units.
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ACLS

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I feel ACLS is a wonderful certification to have. I feel all ICU nurses should obtain it. In emergency cases immediate action is required. With ACLS training, your nurses will be ready and equipped with valuable knowledge that increases the chances of saving your patient's life.
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ANNA members: Please access the interactive web wellness portal www.anahra.org to take the Health Risk Appraisal to identify your personal and professional health, safety, and wellness risk. With this HRA, you can compare personal results against ideal standards and national averages. You will also be helping to bridge a unique nephrology nurse-specific personal and occupational health risk aggregated database. Do it today for your co-workers, your community, and the nursing profession. You will enjoy taking the test and it will generate a lot of thought about your lifestyle and habits.
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Does any nurses have any patients that do the hot style yoga and/or Bikram Yoga? I am helping out in the PD dept. this week and the new pt. I'm training had been practicing yoga before his failed transplant and fell ill. Since I am a yogi myself, I was thrilled he wants to continue in his practice, but also worried about infection, catheter migrating, and or dehydration. I recommended exit site care immediately after, eliminating the "sit-up"and staying well hydrated, He has a good urine output. I will take any advice if anyone has patients who participate in this style of exercise. I'm thrilled he is motivated to be active but very concerned ...
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VLW 2014

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At the VLW in Anaheim....what a great experience-I wish all the ANNA leaders could be here. The networking-meeting nephrology collegues is great. If you can't get to a national ANNA event to just "be" with other nephrology nurses try to create this environment in your area...this is where chapters can shine.
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We are considering initiating utilization of a Bicarbonate Dialysate Mixing and Dispensing System. Some of the Regulatory Requirements in regard to system Disinfection are vague, and we would like to get input as to how often facilities are disinfecting these types of systems - daily vs. weekly etc. Thank you for your input.
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