ANNA journal / American Nephrology Nurses' Association
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Although some of the resources or services listed may seem expensive, it is cheaper to use these than to face a malpractice suit for failure to provide patients with limited English access to services equal to those provided to English speakers. The University of California at San Francisco (UCSF), one of the top three ranking research hospitals in the U. ⋯ The university is now a participant in a statewide effort to provide access to well-trained translator services to the patient population. This effort and the development of an in-house interpreter services department has contributed to a competitive edge for UCSF in the area of patient services and satisfaction as well as attracting more Medicaid patients, which increases their revenues.
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Acute ethylene glycol intoxication is a medical emergency that, if not diagnosed correctly and treated aggressively, will lead to serious neurologic, cardiopulmonary, and renal dysfunction, and may result in death. Ethylene glycol toxicity is characterized by severe metabolic acidosis with high anion and osmolal gaps, and calcium oxalate crystals in the urine. Early recognition of ethylene glycol intoxication and rapid, aggressive use of large amounts of sodium bicarbonate, ethanol infusion, and hemodialysis may improve survival.
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The purpose of this study was to identify and prioritize research topics of importance for nephrology nursing and the American Nephrology Nurses' Association (ANNA). This was an explorative survey design using the Delphi technique. Nephrology nurses who are members of ANNA participated in the study. ⋯ Based on 3 rounds of the Delphi study and analysis of both level of importance and rated-research priority, the five areas that were identified as research priorities are (a) nursing interventions to prevent vascular access infections, (b) nursing interventions to maintain vascular access patency, (c) educational needs of patients and families, (d) levels of nursing competence and the effect on patient outcomes, and (e) validation of nursing interventions to achieve patient outcomes. These research priorities provide direction for nephrology nursing research and the ANNA. This Delphi study represents a significant step for ANNA in its commitment to research.
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Case Reports
Improving physical functioning in the elderly dialysis patient: relevance of physical therapy.
Compromised physical functioning is characteristic of medically complicated patients on dialysis, but many of these deficits can be addressed by rehabilitation. This article describes the benefits and limitations of a 3-month physical therapy pilot program at an inner-city hemodialysis clinic. Program results indicate the difficulties in keeping patients participating in such a program, but, for those patients who did regularly participate, on-site physical therapy consultation was valuable in assisting staff to identify exercise regimens that were consistent with individual patients' needs and addressed their functional difficulties.