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Bridging the gap: innovative approaches to continuing education in rural, remote, and isolated first nation communities.

https://arctichealth.org/en/permalink/ahliterature116349
Source
Semin Dial. 2013 Mar-Apr;26(2):164-8
Publication Type
Article
Author
Tracy Scott
Cynthia Menzies
Glen Chenard
Melissa Spence
Author Affiliation
Saint Elizabeth First Nations, Inuit and Métis Program, Winnipeg, Manitoba. tscott@saintelizabeth.com
Source
Semin Dial. 2013 Mar-Apr;26(2):164-8
Language
English
Publication Type
Article
Keywords
Canada
Education, Nursing, Continuing - trends
Humans
Indians, North American
Internet
Inuits
Minority Groups
Nephrology - education
Rural Health Services - manpower
Rural Population
Abstract
Access to education, communication, and support is essential for achieving and maintaining a skilled healthcare workforce. Delivering affordable and accessible continuing education for healthcare providers in rural, remote, and isolated First Nation communities is challenging due to barriers such as geography, isolation, costs, and staff shortages. The innovative use of technology, such as on-line courses and webinars, will be presented as a highly effective approach to increase access to continuing education for healthcare providers in these settings. A case study will be presented demonstrating how a national, not-for-profit health care organization has partnered with healthcare providers in these communities to support care at the local level through various technology-based knowledge exchange activities.
PubMed ID
23406312 View in PubMed
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CANNT: supporting the Canadian nephrology experience.

https://arctichealth.org/en/permalink/ahliterature176171
Source
CANNT J. 1999;9(3):17-9
Publication Type
Article
Date
1999
Author
D. Gaudet
Author Affiliation
Dr Geogre-L Dumont Regional Hospital, Beaséjour Hospital Corporation, Moncton, New Brunswick.
Source
CANNT J. 1999;9(3):17-9
Date
1999
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Certification
Evidence-Based Medicine
Humans
Kidney Failure, Chronic - epidemiology - therapy
Nephrology - education
Nurse Clinicians
Nursing Research
Personnel Staffing and Scheduling - organization & administration
Registries
Renal Replacement Therapy - nursing
Social Support
Specialties, Nursing - education - organization & administration
Tissue and Organ Procurement - organization & administration
Abstract
The Canadian Organ Replacement Register annual report (1998) provides insightful trends in renal replacement treatment modalities, comparing data from 1981 to 1996. The purpose of reviewing this report was to look at the scope of change over time in the distribution of treatment modalities and Canadian patient demographics: age, gender, dwelling (alternate care facilities, home and in-hospital), and medical conditions (vascular access, communicable diseases, diagnosis, and cause of death). Discussion focuses on the impact of these and other changes in the practice setting and describes the Canadian Association of Nephrology Nurses and Technologists' (CANNT) initiatives to support nephrology nurses and technologists.
PubMed ID
15712468 View in PubMed
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[Critical shortage of personnel in nephrology. Assessment of causes of the crisis and suggestion for solution]

https://arctichealth.org/en/permalink/ahliterature34565
Source
Tidsskr Nor Laegeforen. 1996 Nov 20;116(28):3348-51
Publication Type
Article
Date
Nov-20-1996
Author
K P Nordal
A. Hartmann
T. Leivestad
S. Halvorsen
B M Iversen
T E Widerøe
J. Julsrud
Author Affiliation
Nyreseksjonen, Medisinsk avdeling B, Rikshospitalet, Oslo.
Source
Tidsskr Nor Laegeforen. 1996 Nov 20;116(28):3348-51
Date
Nov-20-1996
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Child
Employment
English Abstract
Humans
Middle Aged
Nephrology - education - manpower - standards
Norway
Physicians
Workload
Abstract
The heavier work load for qualified nephrologists in Norway over the last ten years is described and compared with the number of positions. The increase in the number of dialysis treatments, care of renal transplant patients and other tasks performed by qualified nephrologists is roughly doubled from 1985 to 1995. By contrast the number of employed qualified nephrologists to pursue the work has only increased by 20% over the same period. As of today there is a lack of capacity to educate new nephrologists to fill up forthcoming vacancies. When the actual need for nephrologists is taken into account, the discrepancy is much more serious and will become even more so over the next ten years if no immediate action is taken. We suggest the establishment of six new educational positions. Altogether, these six new positions will provide the capacity to educate a reasonable number of trained nephrologists to meet future challenges, to the benefit of patients.
PubMed ID
9011993 View in PubMed
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Hemodialysis prescription education decreases intradialytic hypotension.

https://arctichealth.org/en/permalink/ahliterature123315
Source
J Nephrol. 2013 Mar-Apr;26(2):315-22
Publication Type
Article
Author
Davina J Tai
Joslyn Conley
Pietro Ravani
Brenda R Hemmelgarn
Jennifer M MacRae
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Alberta - Canada; and Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Source
J Nephrol. 2013 Mar-Apr;26(2):315-22
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Attitude of Health Personnel
Chi-Square Distribution
Education, Medical, Continuing
Female
Health Knowledge, Attitudes, Practice
Humans
Hypotension - diagnosis - epidemiology - physiopathology - prevention & control
Logistic Models
Male
Middle Aged
Nephrology - education
Odds Ratio
Prevalence
Renal Dialysis - adverse effects
Retrospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Intradialytic hypotension (IDH) is associated with increased morbidity and mortality. We studied the impact of an education program and hemodialysis (HD) prescription optimization on the frequency of IDH.
We compared chronic HD patients during 2 retrospective time periods: a control period and the study period which occurred after 2 months of physician education and HD prescription optimization. Primary study outcomes were the frequency of HD sessions complicated by IDH, and the prevalence of IDH-prone patients.
There were 91 and 82 patients in the control and study periods, respectively. In the study period, 11% (115/1107) of HD sessions were complicated by IDH vs. 17% (189/1103) in the control period (p = 0.0002). There was a decreased odds ratio for IDH in the study period compared with control (odds ratio [OR] = 0.59; 95% confidence interval [95% CI], 0.40-0.86; p = 0.007). Compared with control, more patients in the study period were prescribed at least 2 preventative strategies (42% vs. 61%, p = 0.02), including increased use of cool dialysate (55% vs. 89%, p
PubMed ID
22711438 View in PubMed
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Nephrologists' reported preparedness for end-of-life decision-making.

https://arctichealth.org/en/permalink/ahliterature161850
Source
Clin J Am Soc Nephrol. 2006 Nov;1(6):1256-62
Publication Type
Article
Date
Nov-2006
Author
Sara N Davison
Gian S Jhangri
Jean L Holley
Alvin H Moss
Author Affiliation
Division of Nephrology and Immunology, University of Alberta, Edmonton, Alberta, Canada. sara.davison@ualberta.ca
Source
Clin J Am Soc Nephrol. 2006 Nov;1(6):1256-62
Date
Nov-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Decision Making
Humans
Kidney Failure, Chronic - mortality
Middle Aged
Nephrology - education
Questionnaires
Societies, Medical
Terminal Care
United States
Abstract
Nephrologists commonly engage in end-of-life decision-making with patients with ESRD and their families. The purpose of this study was to determine the perceived preparedness of nephrologists to make end-of-life decisions and to determine factors that are associated with the highest level of perceived preparedness. The nephrologist members of the Renal Physicians Association (RPA) and the Canadian Society of Nephrology were invited to participate in an online survey of their end-of-life decision-making practices. A total of 39% of 360 respondents perceived themselves as very well prepared to make end-of-life decisions. Age >46 yr, six or more patients withdrawn from dialysis in the preceding year, and awareness of the RPA/American Society of Nephrology (ASN) guideline on dialysis decision-making were independently associated with the highest level of self-reported preparedness. Nephrologists who reported being very well prepared were more likely to use time-limited trials of dialysis and stop dialysis of a patient with permanent and severe dementia. Compared with Americans, Canadian nephrologists reported being equally prepared to make end-of-life decisions, stopped dialysis of a higher number of patients, referred fewer to hospice, and were more likely to stop dialysis of a patient with severe dementia. Nephrologists who have been in practice longer and are knowledgeable of the RPA/ASN guideline report greater preparedness to make end-of-life decisions and report doing so more often in accordance with guideline recommendations. To improve nephrologists' comfort with end-of-life decision-making, fellowship programs should teach the recommendations in the RPA/ASN guideline and position statement.
PubMed ID
17699356 View in PubMed
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Nurse practitioners in the Northern Alberta Renal Program.

https://arctichealth.org/en/permalink/ahliterature161941
Source
CANNT J. 2007 Apr-Jun;17(2):48-50
Publication Type
Article
Author
Julie Nhan
Sylvia Zuidema
Author Affiliation
Northern Alberta Renal Program, University ofAlberta Hospital, Edmonton, Alberta. julienhan@capitalhealth.ca
Source
CANNT J. 2007 Apr-Jun;17(2):48-50
Language
English
Publication Type
Article
Keywords
Alberta
Ambulatory Care - organization & administration
Cooperative Behavior
Cost-Benefit Analysis
Education, Nursing, Graduate
Humans
Nephrology - education - organization & administration
Nurse Practitioners - education - organization & administration - psychology
Nurse's Role - psychology
Nursing Evaluation Research
Physician-Nurse Relations
Professional Autonomy
Quality of Health Care
Abstract
The presence of nurse practitioners (NPs) in nephrology is not a new concept; literature out of the United States documents their existence quite well Since 1973, the collaboration of NPs and nephrologists has provided cost-effective care for dialysis patients and an alternative for health authorities anticipating a nephrologist shortage. Integration of NPs ensures high-quality, cost-effective, patient-focused care. In 1995, NPs began their integration into the Canadian nephrology field and, in 2004, the Northern Alberta Renal Program (NARP) hired its first nurse practitioner. Currently, there are five NPs who work collaboratively with nephrologists to manage and co-ordinate nephrology care. This article will review the history of NPs in Canada and the introduction of NPs in NARP.
PubMed ID
17691711 View in PubMed
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A study of online consultations for paediatric renal patients in Russia.

https://arctichealth.org/en/permalink/ahliterature138590
Source
J Telemed Telecare. 2011;17(2):99-104
Publication Type
Article
Date
2011
Author
Julia Braverman
Dmitry V Samsonov
Author Affiliation
Division on Addictions, Cambridge Health Alliance, 101 Station Lnd, 2 floor, Boston MA 02155, USA. braverju@gmail.com
Source
J Telemed Telecare. 2011;17(2):99-104
Date
2011
Language
English
Publication Type
Article
Keywords
Child
Computer Communication Networks - standards
Consumer Satisfaction
Female
Humans
Internet
Kidney Diseases - diagnosis - therapy
Male
Nephrology - education
Parents - education
Remote Consultation - standards
Russia
Abstract
We developed an educational website for parents of paediatric patients with kidney diseases in Russia. Parents could ask questions regarding their child's illness and submit information, including medical summaries and scanned or electronic images. A US-trained specialist in paediatric nephrology reviewed the information provided and advised about further evaluation or referral, as well as discussing possible treatment plans. In the first nine months, 141 distinct users communicated through the website. Fifty-eight percent of patients were female. An analysis of 70 cases suggested that in 45% there had been overdiagnosis of common paediatric problems, such as urinary tract infection and pyelonephritis. Users completed an anonymous satisfaction survey. The response rate was 84% (n = 59/70). The majority of respondents found the consultation useful (mean = 4.6 on a 5-point scale). The online consultation answered the questions of most respondents, provided useful information and relieved uncertainty regarding a follow-up. The majority of the respondents (>90%) confirmed that they trusted the online consultation and would recommend the technique to other parents. Online consultation for parents can provide reliable information that results in improved parental satisfaction and education. This approach may be useful in improving care and providing patient education in underserved areas in the USA and elsewhere.
PubMed ID
21163814 View in PubMed
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Temporary hemodialysis catheter placement by nephrology fellows: implications for nephrology training.

https://arctichealth.org/en/permalink/ahliterature113802
Source
Am J Kidney Dis. 2013 Sep;62(3):474-80
Publication Type
Article
Date
Sep-2013
Author
Edward G Clark
Michael E Schachter
Andrea Palumbo
Greg Knoll
Cedric Edwards
Author Affiliation
Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. edward.clark@uottawa.ca
Source
Am J Kidney Dis. 2013 Sep;62(3):474-80
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Canada
Catheterization, Central Venous - methods
Health Surveys
Humans
Internship and Residency - methods
Nephrology - education - methods
Renal Dialysis - methods
Time Factors
Abstract
The insertion of temporary hemodialysis catheters is considered to be a core competency of nephrology fellowship training. Little is known about the adequacy of training for this procedure and the extent to which evidence-based techniques to reduce complications have been adopted. We conducted a web-based survey of Canadian nephrology trainees regarding the insertion of temporary hemodialysis catheters. Responses were received from 45 of 68 (66%) eligible trainees. The median number of temporary hemodialysis catheters inserted during the prior 6 months of training was 5 (IQR, 2-11), with 9 (20%) trainees reporting they had inserted none. More than one-third of respondents indicated that they were not adequately trained to competently insert temporary hemodialysis catheters at both the femoral and internal jugular sites. These findings are relevant to a discussion of the current adequacy of procedural skills training during nephrology fellowship. With respect to temporary hemodialysis catheter placement, there is an opportunity for increased use of simulation-based teaching by training programs. Certain infection control techniques and use of real-time ultrasound should be more widely adopted. Consideration should be given to the establishment of minimum procedural training requirements at the level of both individual training programs and nationwide certification authorities.
Notes
Comment In: Am J Kidney Dis. 2014 Feb;63(2):346-724461680
Comment In: Am J Kidney Dis. 2014 Feb;63(2):34624461681
PubMed ID
23684144 View in PubMed
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8 records – page 1 of 1.