Good Resource for Learning Adequacy Measurements?

Specialties Urology

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

I recently made the transition from acutes to chronics with one of the "Big Two" HD companies. While I am much happier in chronics, I am still not entirely "getting" the whole Kt/V, ekrdt/V (I think!), OSL, Tattersal, etc. thing, because we didn't have to worry about it in acutes, since our patients were all short term. I mean, I know what the goal parameters are (Kt/V >1.2, etc.), but I don't really understand how they get the numbers or how they apply to the various aspects of the treatments except that they are affected if the patient comes off early, skips treatments, or has a poor BFR.

I have talked to my very kind and supportive manager, and she is agreeable to me getting more training in that regard, but the fact is that we are just too busy and short staffed to spare me to attend classes, so I haven't really mentioned it again. However, the more I work in chronics, the more I realize that I really need a good understanding of HD adequacy, particularly when doing patient care plans or instructing the techs during treatments. I am getting by right now on my limited knowledge, but that's not good enough for me, I think my patients deserve to have a nurse who has a deep understanding of what they need vs. what they are getting.

I already purchased this book from Amazon when I started working in dialysis:

http://www.amazon.com/Review-Hemodialysis-Nurses-Dialysis-Personnel/dp/0323077021/ref=sr_1_3?s=books&ie=UTF8&qid=1395188328&sr=1-3&keywords=dialysis

but it doesn't really get into details about adequacy.

Can anyone recommend a really good resource, either a book or online resource, that would give me a very good comprehension of HD adequacy measurements and how they apply to individual treatments? I have been given a few pages of resources at work, but they are somewhat limited. I'm talking about more of a book or online tutorial.

Thanks!

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Specializes in Nephro-Dialysis / Intervention Radio.

KDOQI Guidelines

http://kidneyschool.org

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

Thank you so much! These are very helpful.

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Specializes in Nephro-Dialysis / Intervention Radio.

You're welcome.

The KDOQI guidelines have a history and rationale behind arriving at these adequacy numbers. You will find it very interesting.

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Specializes in ICU, previously Dialysis.

Depending on which company you're at, there is a learning course you do for adequacy too.

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

I didn't get the course because I was hired for acutes where we don't use adequacy measures. I have asked a couple of times if I can take it, but because we're so short handed, the idea seems to be that I will pick it up as I go instead of sitting down and learning it from our education coordinator. Bummer!

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Specializes in ICU, previously Dialysis.

Yes I know. I started in acutes. Then moved in center to be a Clin Coord/CNM so I understand your dilemma. At the other company, we can sign ourselves up for just about any learning course. But if they don't want you to do it on working time, u can also see that dilemma.

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Specializes in ICU, previously Dialysis.
Yes I know. I started in acutes. Then moved in center to be a Clin Coord/CNM so I understand your dilemma. At the other company we can sign ourselves up for just about any learning course. But if they don't want you to do it on working time, I can also see that dilemma. Sent from my iPhone using allnurses.com[/quote']

Sent from my iPhone using allnurses.com

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