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Objective: The purpose of this study was to determine nephrology nurses' perceptions of barriers to research utilization and to identify effective ways to facilitate integration of research findings in nephrology nurses' practice., Design: This was an explorative, descriptive study., Sample/setting: Four hundred ninety-eight nephrology nurses participated in the study. The primary areas of clinical practice were hemodialysis (36%), peritoneal dialysis (29%), transplantation (15%), pediatric nephrology (3%), or various combinations (18%)., Methods: Participants completed a demographic data form and the previously validated instrument, Barriers and Facilitators to Using Research in Practice. Descriptive statistics were used to analyze the data., Results: The majority of respondents (52%) were staff nurses. The other respondents included 30% in management, 12% in advanced practice roles, and 6% in education. The barriers to research utilization most frequently identified were insufficient time on the job to implement new ideas and not enough time to read research. The most effective facilitators identified were increased administrative support and encouragement, increased time available for reviewing and implementing research findings, and improved understandability of research reports., Conclusions: Additional nursing and nonnursing administrative support for research activities and designated time to read research and implement research-based clinical practices may facilitate the development of research-based nephrology nursing practice.

Objective: The purpose of the study was to obtain information from nephrology nurses on existing policies and protocols related to peritoneal catheter exit site care and treatment of exit site infections., Design: This was an explorative, descriptive study., Sample/setting: Fifty-four nurses who attended the 1995 Consensus Conference on Peritoneal Dialysis at the 26th Annual American Nephrology Nurses' Association National Symposium completed a survey questionnaire on exit site care and management of exit site infections., Methods: A survey was mailed to nephrology nurses preregistered to attend the 1995 ANNA Consensus Conference related to peritoneal dialysis at the 26th National Symposium. Surveys were also collected at the meeting., Results: Hydrogen peroxide and povidone iodine are frequently used in the nursing care of both healing and chronic exit sites. Almost all of the dialysis units require patients to stabilize or secure the catheter. The majority of respondents had a standardized method of assessing exit sites. Risk factors for exit site infections are presented for both the immediate post-catheter insertion period and the well-healed exit site. There were many different combinations of cleansing agents used to treat inflamed and infected exit sites., Conclusions: Procedures for exit site care vary widely. Prospective, randomized studies of exit site care protocols and cleansing agents are necessary to determine the most effective procedures to promote healthy exit sites.

This article brings attention to the need for disaster preparedness by individual dialysis facilities. It is recommended that each facility develop a specific plan for each type of disaster that might occur in the particular geographic location. It is also recommended that the community's disaster plan(s) be reviewed and incorporated in the planning process. This article addresses all aspects related to a natural disaster, including planning, drills, basic services, personnel, and the aftermath. Adequate preparation may lessen the destruction and negative consequences of a natural disaster.

Medicare regulations require follow-up home visits to home dialysis patients, yet routine home visits require a lot of personnel time. The effectiveness of home visits was evaluated by a nurse, dietitian and social worker using a questionnaire. Thirty-six patients were evaluated during an 18-month period. Collectively the team documented an average of 10 pertinent observations per visit and made an average of 4 recommendations for change. Staff members gained new information about the patient as indicated by the fact that they changed their rankings on 5 of 15 parameters following the home visit. The home visit policy that recommended an annual home visit was revised to recommend a single home visit for each new peritoneal dialysis patient. Further visits are performed only if significant problems are identified.

The peritoneal equilibration test is used to assess peritoneal membrane permeability. Results provide a reliable estimate of peritoneal clearances and ultrafiltration rates. This information can be used to make decisions about the preferred dialysis prescription. Repeat tests may be used to evaluate clinical changes. The first part of this two-article series will discuss the clinical interpretation of findings and three case studies. The second article will describe the procedure.

This article, part 2 of a 2-part series, describes the process and procedures used to perform a peritoneal equilibration test. Data from the test may be used to assess the peritoneal membrane permeability. Knowledge of peritoneal membrane permeability may be useful in selecting a treatment regimen and in determining the appropriate dialysis prescription.

This article presents a nursing care plan and patient education plan for patients receiving recombinant human erythropoietin in the form of Epogen (Epoetin alfa). Eight nursing diagnoses and a standard and outcomes for patient education are included.

Very high glucose concentrations falsely elevate measured creatinine. An appropriate correction factor may be applied to obtain an accurate creatinine value; however, the glucose interference is of a low magnitude in most dialysate samples at a 4-hour dwell time. Clinical interpretation of the peritoneal equilibration test using uncorrected creatinine values to determine the dialysate-to-plasma ratio at 4 hours is associated with minimal error.

The purpose of this in vitro study was to evaluate the effectiveness of continuous ambulatory peritoneal dialysis (CAPD) procedures. Four procedures to disinfect the catheter adapter/transfer set connection were compared in vitro using a mock sterile CAPD system.

Fifty-four percent of all dialysis patients followed by a single center had elevated serum phosphorus levels on more than 25% of all measurements. A phosphorus patient education program was developed and implemented and knowledge was measured with a pretest and posttest. The continuous ambulatory peritoneal dialysis group had a significant increase in knowledge and a minor, but statistically significant, decrease in serum phosphorus after participating in the education program. In contrast, center hemodialysis patients did not demonstrate a significant increase in knowledge or decrease in serum phosphorus. These different outcomes could not be attributed to specific differences between the two groups. Serum phosphorus control is a complex process, and this education program did not result in a clinically significant improvement in serum phosphorus levels.