Literature review on renal nursing

This literature review sheds light on the profession of renal nursing and the areas in which they can expose their nursing skills. It also peeks into the different programs, which the renal nurses are offered.

Running head: MANAGEMENT
Literature review on renal nursing
Name of the student:
Name of the university:
Author note:

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‘Career opportunities in renal nursing: A revolution in the case of peritoneal
analysis’
Introduction
Renal nursing is a concept used for gaining an understanding about the cure
and treatment related to kidney diseases. Timely intervention of the healthcare
professionals through latest and modern technologies helps in preventing the risks
from aggravating the health risks and conditions. This assignment attempts to
prepare a literature review on the concept of renal nursing through the consideration
of scholarly viewpoints (Richardson & Whatmore, 2014). This background leads to
the formulation of the aims and objectives, adding a proper direction to the research.
Once the aims and objectives are prepared, questions are developed, which is
assistance in shedding light on the hypothetical approach of the concepts through
theoretical considerations.
Background
In every hospital, there is a renal unit, catering to patients suffering from
kidney diseases. Nurses are instructed to assist the doctors in conducting Peritoneal
analysis, where transplantation is the main surgery. As a matter of specification, the
nurses are instructed to maintain a courteous approach to the service users for
gaining their respect, loyalty and dependence. The renal unit team comprises of a
Nurse Manager, 3 senior staffs, volunteering the performance of the nurses, care
assistants, who are in charge of haemodialysis (Annanurse.org, 2019). Along with
this, there is also a patient administrator.
Before starting the treatment, the patients are allocated a named nurse, who
gains a special interest in the treatment. The patients can approach one of the
nurses if they have a query related to the treatment and the service availed. These
nurses are to directly report to the renal doctors. Doubts regarding the treatment of
the kidney diseases can also be cleared through the nurses. The nurses prepare the
case history of the patients by consulting the dieticians (Annanurse.org, 2019).
Peritoneal Dialysis

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A senior staff nurse is assigned the charge of taking care of the patients who
are to undergo peritoneal dialysis. The senior nurse gets the assistance of two staff
nurses, who takes care of the patient in the absence of the senior staff nurse.
Roles of a nephrology/renal nurse
A nephrology or renal nurse is entrusted with the responsibility to accomplish
the allocated duties within the hospital settings. Performing the haemodialysis for the
outpatients is accounted as an essential function of the nephrology or renal nurse.
Other treatments like transplantations, organ recovery, and managing quality of the
pharmacy stock is executed by the nurses under the supervision of the Nurse
Manager. In this process, the standards and guidelines of the Advanced Nursing
Practices are followed (Annanurse.org, 2019). Along with this, state and territory
regilations also apply in the responsibilities of a renal nurse. Delivery of spontaneous
care and treatment to the patients with chronic kidney disease is accounted as the
most important duty of a renal nurse.
Assessment of the patient condition helps the nurses in preparation of the
action plans to deliver effective medication. For this, collaboration with the members
of other departmental units is an effective option for standardizing the treatment
services. Explaining the treatment methods to the patients and their families also
falls within the essential responsibilities of the renal nurse (Annanurse.org, 2019).
Practice areas
The renal nurses are provided with the opportunity to practice their skills in the
primary, secondary and tertiary care settings. In case of the outpatients, the renal
nurse plays an important role, representing the member of the multidisciplinary team.
As a matter of specification, the nurses play the role of advocate, educator,
consultant, direct caregiver. Understanding and caring approach enhance the
stability in the relationship between the patients and the nurses. Pursuing the field of
nephrology broadens the avenues of careers for the nurses in the field of education,
management, research, case management, advanced nursing, corporate
governance and pediatric nephrology (Annanurse.org, 2019).
Significance

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This literature review sheds light on the profession of renal nursing and the
areas in which they can expose their nursing skills. Along with this, insight into the
various levels of practice helps the readers to gain an insight into the roles, which the
nephrology nurses perform in the hospital care settings. Apart from this, the literature
review peeks into the different programs, which the renal nurses are offered. These
programs act as a career development plan for the nurses. Consideration of
scholarly reviews and articles enriches the knowledge, skills and expertise of the
readers regarding the different practices adopted for providing cure and treatment to
the patients. The concepts like JBL and prisma diagram adds value to the proposed
arguments and the counter arguments.
Aims and objectives
The literature review is aimed at investigating the various programs, which
drives the nephrology/renal nurses towards their professional development. Based
on this aim, the following objectives can be identified:
 To identify the programs introduced by American Nephrology Nurses’
Association
 To investigate the amounts of certificate courses developed for the nurses
 To examine the impact of scholarships on the skill development of the
nephrology nurses
 To excavate the appraisal tools and techniques adopted by the American
Nephrology Nurses for enhancing the career opportunities of the nurses
 To suggest recommendations in the field of nephrology so that the nurses can
attain professional development.
Discussion
Research questions
Using the PICO framework, the following questions can be formed for
conducting the literature review:
Framework item Thoughts Example
Patient
problem/population
What demographic details
are essential for defining
the problem type?
Socio-cultural background
of the patients suffering
from chronic kidney

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disease
Intervention What are the measures
taken by the scientists for
providing quality cure and
support?
Dialysis and
transplantation
Comparison/control What are the forms of
dialysis and
transplantation adopted
by the other hospitals?
Medical management
Outcome What is the anticipated
outcome of the treatments
and care plans?
Extension of the Medicare
facilities, benefitting the
patients and the hospital
staffs
Table: PICO framework for the research questions on Nephrology/Renal
Nursing
(Source: Created by the author)
Search strategy
Keywords
Renal nursing, Nephrology, American Nephrology Nurses’ Association, PICO
framework.
Databases
The databases used for this research are journal articles based on renal
nursing practices and websites of American Nephrology Nurses’ Association.
Methods
The literature review was conducted through secondary methods. Within
this, mention can be made of the qualitative means, where relevant journal articles
and websites were used for collecting information on the nephrology nursing
practices in the healthcare settings.

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Article inclusion
PRISMA 2009 Flow Diagram
Fig: Prisma diagram for inclusion of articles in the literature review
(Source: Created by the author)
Records identified through
database searching
(n = 15 )
Sc
re
en
in
g
In
cl
ud
ed
Eli
gib
ilit
y
Id
en
tifi
ca
tio
n
Additional records identified
through other sources
(n = 5 )
Records after duplicates removed
(n = 5 )
Records screened
(n = 15 )
Records excluded
(n = 10 )
Full-text articles assessed
for eligibility
(n = 5 )
Full-text articles excluded,
with reasons
(n = 7 )
Studies included in
qualitative synthesis
(n = 5 )
Studies included in
quantitative synthesis
(meta-analysis)
(n = 0)

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The above Prisma diagram depicts the methods adopted for eliminating the
irrelevant articles and reaching to the relevant articles. Typical components in this
process were identification, screening, eligibility and inclusion. At the initial
stage, 15 records related to the field of renal nursing were identified. Along with this,
additional 5 sources were considered for gaining adequate information. As a
sequential stage, all of the considered articles were screened, which assisted in
detecting the relevant and the irrelevant articles. As a result of this, the duplicate
articles were removed. Among the records and the articles, 10 of them were
excluded, as it did not match the eligibility criteria.
The sources consisted of full text articles. 5 out of 15 articles were full text,
which were assessed for assessing the eligibility. 7 of the articles were such, which
were full texts. These were excluded with reasons. Mention can be made of 5
articles, which were included, as it comprised of qualitative synthesis. On the other
hand, none of the articles were meta-analysis, so the literature review was exempted
from this criteria.
Article appraisal
Yes No Unclear Not applicable
Congruity between the stated
philosophical perspective and the
research methodology

Congruity between the research
methodology and the research question
or objectives

Congruity between the research
methodology and the methods used to
collect data

Congruity between the research
methodology and the representation
and analysis of data

Congruity between the research
methodology and the interpretation of
results


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Statement locating the researcher
culturally or theoretically
Unclear
Influence of the researcher on the
research, and vice- versa, addressed

Participants, and their voices,
adequately represented

Research ethical according to current
criteria or, for recent studies, and is
there evidence of ethical approval by an
appropriate body?

Conclusions drawn in the research
report flow from the analysis, or
interpretation, of the data

Overall appraisal: Include Exclude □ Seek further info □
Table: JBL technique for appraising the articles for literature review
(Source: Created by the author)
According to the table, the parameter considered for appraising the five
articles is congruity between the propositions and the selected methodology. All of
the selected articles qualify in this parameter. One of the important aspect in this
article is that ethical considerations, which adds reliability, validity and authenticity to
the proposed arguments. In some of the articles, the location of the researcher
culture and theoretical justification is ambiguous. The voice of the samples are
represented through data analysis. Influence of the researcher on the researcher is
reflected from the ‘gaps in literature’, which depicts the efforts towards highlighting
the weakness and drawbacks.
Results and discussion
The first article concludes that renal placement therapy is one of the
significant aspects within the nursing principles within the profession of nephrology.
Considering the arguments of Engel and Pugh, (2019), renal nutrition basics need to
be delivered to the nurses for providing quality care, treatment and support to the
patients suffering from kidney disease. On the contrary, Bergjan and Schaepe,

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(2016) concludes that consideration of the challenges in peritoneal dialysis enhances
the experiences of the nurses in terms of providing the care, treatment and support.
Affirming with the arguments of Urstad et al., (2018), it can be inferred that new
patient programs in renal transplants proves beneficial in terms of enhancing the
standards and quality of the education programs. Rutherford, van den Bosch and
Warren, (2015) argues that there is a need for review of predialysis education
programs, which would standardize the services.
As per the arguments of Scammell, Heaslip and Crowley, (2015), involvement
of the service users in the general nurse education is carried out through pre-
registration, which aligns with the initiatives towards standardizing the nursing
practices in the field of nephrology. On the other hand, McKenzie and Addis, (2018)
infers that job satisfaction is one of the essential characteristic traits of the renal
nurses. Maursetter et al., (2018) is of the view that innovations in the scholarship
programs is assistance in terms of standardizing the dialysis programs. On the
contrary, Strupeit, Buss and Dassen, (2016) opines that nurse delivered patient
centric education intervention programs upgrades the standards of living for the
elders suffering from kidney diseases. These programs expand the scope and arena
of the knowledge horizons in case of the renal nurses.
Conclusion and implications
After reviewing the considered articles, it can be concluded that innovations
are needed in the programs of nephrology and renal trainings. In this process, the
standards of American Nephrology Nurses Association is followed for executing the
renal nursing practices in an efficient and effective manner. Development of the long
term goals in the strategies is assistance in terms of adding innovation into the
scholarship programs. These programs is further assistance in terms of planning the
career enhancement for the nurses. Training the staffs about the recent dialysis
trends and practices would upgrade their skills, knowledge and abilities, concretizing
their medical experience.
Post training tests are beneficial in terms of assessing the capability of the
nurses in terms of curing the kidney failure diseases through dialysis. Board
meetings are needed in terms of planning quality scholarship programs for the
nurses. Frequent inspections are needed for measuring the extent to which the

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nursing practices align with the National Health Standards. Feedbacks from the
nurses would be effective means for gaining an insight into their needs, demands
and requirements.

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References
Annanurse.org (2019). Achieve your goals: Make a difference Join a community of
caring. Retrieved 17th September 2019 from
https://www.annanurse.org/download/reference/membership/discover.pdf
Bergjan, M., & Schaepe, C. (2016). Educational strategies and challenges in
peritoneal dialysis: a qualitative study of renal nurses’ experiences. Journal of
Clinical Nursing, 25(11-12), 1729–1739. doi:10.1111/jocn.13191
Engel, B., & Pugh, P. (2019). Renal nutrition. Renal Nursing: Care and Management
of People with Kidney Disease, 367-411. [https://doi.org/10.1111/nicc.12120]
Maursetter, L. J., Prince, L. K., Yuan, C. M., & Simon, J. F. (2018). Sharing
innovations to enhance renal fellow education in dialysis. Seminars in
Dialysis, 31(2), 163–169. doi:10.1111/sdi.12662
McKenzie, A. T., & Addis, G. (2018). Renal inpatient ward nurse experience and job
satisfaction: A qualitative study. Journal of Clinical Nursing.
doi:10.1111/jocn.14552
Richardson, A., & Whatmore, J. (2014). Nursing essential principles: continuous
renal replacement therapy. Nursing in Critical Care, 20(1), 8–15.
doi:10.1111/nicc.12120
Rutherford, P., van den Bosch, J., & Warren, S. (2015). Review of predialysis
education programs: a need for standardization. Patient Preference and
Adherence, 1279. doi:10.2147/ppa.s81284
Scammell, J., Heaslip, V., & Crowley, E. (2015). Service user involvement in
preregistration general nurse education: a systematic review. Journal of
Clinical Nursing, 25(1-2), 53–69. doi:10.1111/jocn.13068
Urstad, K. H., Wahl, A. K., Engebretsen, E., Larsen, M. H., Vidnes, T. K., Stenwig, A.
G. K., … Andersen, M. H. (2018). Implementation of a new patient education
programme for renal transplant recipients. Journal of Renal Care, 44(2), 106–
114. doi:10.1111/jorc.12236

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