Assessment and critical thinking improve outcomes in nephrology

Action 2000: assessment and critical thinking improve outcomes in nephrology

September 22-24, 2000 * Philadelphia, PA October 20-22, 2000 * Chicago, IL

The purpose of ANNA’s ACTION meeting is to provide an opportunity for nephrology nurses and nurses caring for patients with renal disease to learn and share the clinical challenges specific to this special population.

Special features of the ACTION 2000 meeting include:

* Short courses in Transplant, Hemodialysis, and Anticoagulation as part of the Essentials for Nephrology Nursing.

* Over 10 contact hours of content, which qualifies as fundamentals for nephrology nursing (application submitted).

* Breakfast provided everyday, lunch provided on Sunday, and a reception Saturday evening.

* Sessions designed for all learning levels and experience.

Program Committee

Mary Gritzmaker Schira, PhD, RN, CS, Advisor Mary P. Cwiertniewicz, MSN. RN, CNN. CRNP Karen Prussing, MS, CS, CNN, ANP

Director of Professional Development

Linda J. Smith, MSN, RN, CNN, C



12 noon-4:30 pm Nephrology Nursing Certification Examination (Separate registration form and fee are required. See page 7 for more information)

1:00 pm-6:30 pm Registration Open for ANNA ACTION 2000

2:00 pm-5:30 pm Concurrent Optional Sessions (Separate registration fee required. See page 7 for more information)

2:00 pm-3:15 pm Journal Club: Evidence-Based Practice The Journal Club Session is 150 minutes or 3.0 contact hours Charlotte Thomas-Hawkins PhD, RN CNN

This session will be based on two articles published in the Nephrology Nursing Journal that provide evidence about diabetic ESRD patients with foot complications. One article is a research study related to the incidence of amputation in diabetic ESRD patients and diabetics without ESRD: the other is an opinion. Common threads of diabetes and ESRD will be woven with USRDS data and American Diabetic Association (ADA) Guidelines for foot care. Details for obtaining articles will be in the confirmation letter.

* Define evidence-based practice.

* Identify sources of evidence that serve as a basis for practice.

* Evaluate research as one source of evidence-based practice.

3:15 pm-3:45 pm Break

3:45 pm-5:00 pm Journal Club (continued)

* Describe how to incorporate evidence from USRDS into nursing practice.

* Identify non-nephrology sources of evidence the nephrology nurse can use in practice.

* Explain how to integrate numerous sources of evidence related to prevention of diabetic complications in practice.

The following program is a module from the developing curriculum titled Essentials in Nephrology Nursing. The purpose of the project is to develop a series of modules containing content that has been identified as fundamental nephrology nursing by the Nephrology Nursing Certification Board. The project is designed to advance the learner’s knowledge of nephrology nursing and clinical practice with the learning event providing opportunities to strengthen problem solving and critical thinking skills through clinical case studies.

2:00 pro-3:30 pm Essentials in Nephr010gy Nursing Module Clinical Applications of Anticoagulation Therapy: The Thick and the Thin of It **

The Anticoagulation Session is 180 minutes or 3.6 contact hours. Christine M. Chmielewski, MS, CRNP, CS, CNN Debra Castner, MSN, RN, NP-C, CNN

This program will explore the use of anticoagulation therapy in nephrology nursing practice. The primary focus is the application of anticoagulation therapy in the care of the person with ESRD. The mechanisms of coagulation will be reviewed, as will factors that contribute to the state of hypercoagulability. Through an interactive format, case studies will be analyzed to illustrate patient assessment, interventions, and evaluation principles and practice. Case studies used in the program are built upon clinical situations experienced by the presenters in their nephrology nursing practices.

* Describe the mechanism of anticoagulation.

* Gather appropriate clinical ,assessment data related to the patient’s homeostasis functioning.

* Identify key concepts for patient education related to anticoagulation.

* Evaluate the patient’s response to therapy based on outcome assessment.

* Recommend adjustments in the anticoagulation regimen based on clinical assessment data to achieve the desired patient response.

3:30 pm-4:00 pm Break

4:00 pm-5:30 pm Clinical Applications of Anticoagulation Therapy (continued)


7:30 am-8:55 am Continental Breakfast in Exhibit Ball

8:55 am-9:00 am Introductions

9:00 am-10:00 am General Session Status and Future Trends of Patients with Renal Disease **

Using a variety of data sources, this general session will look at the current and future challenges facing patients with ESRD in the context of the common modalities. The progress in identifying the populations at risk for chronic renal insufficiency (CRI) will be reported.

Chronic Renal Insufficiency (CRI) Karen Prussing, MS, CS, CNN, ANP

* Explain the clinical and economic benefits of early identification and referral of patients with kidney disease.

* identify the challenges in monitoring the progression of chronic renal failure (CRF), pre-ESRD assessment, and the initiation of renal replacement therapy.

Transplant Jean Colanari, MS, RN, CNN (Philadelphia) Patricia D. Weiskittel, MSN, RN, CNN, CS (Chicago)

* Discuss the major roadblocks facing the transplant community.

* Explain the projected impact of current legislation on organ allocation.

* Discuss potential solutions to the organ shortage.

10:00 am-11:00 am Visit Exhibit Hail

11:00 am-12:00 noon Status and Future Trends of Patients with Renal Disease ** (continued)

Hemodialysis Mary P. Cwiertniewicz, MSN, RN, CNN, CRNP

* Describe how the regulatory agencies have affected standards of practice in nephrology nursing.

* Discuss the evolution of quality of life and end-of-life issues as the severity of illness and age increases in the ESRD population.

Peritoneal Dialysis Donna M. Smolen, BSN, RN, CNN

* Describe the current characteristics of patients on PD therapies.

* Discuss the changing characteristics of patients on PD and the impact on nursing care.

12:00 pm-1:45 pm Lunch on your own

1:45 pm-3:00 pm Concurrent Sessions

Renal Osteodystrophy ** Clara O. Neyhart, BSN, RN, CNN

* Identify the etiologies and physiologic conditions related to renal osteodystrophy.

* Describe the management of renal osteodystrophy.

* Evaluate the patient’s response to renal osteodystrophy therapies.

Pharmacology in the Transplant Patient ** Jean Colanari, MS, RN, CNN (Philadelphia) Patricia D. Weiskittel, MSN, RN, CNN, CS (Chicago)

* List the various classifications of immunosuppressive agents.

* Discuss the side effects of the immunosuppressive agents and their impact on patient quality of life.

* Identify drug interactions occurring with the immunosuppressive agents.

* Discuss the rationale for current combination therapies.

Peritoneal Dialysis ** Donna M. Smolen, BSN, RN, CNN

* Identify the patient population who are on PD by default.

* Discuss the problems associated with patients who are not primary candidates for the PD modality.

* Develop a plan of care for the patient with ESRD who is totally dependent on PD for survival.

Hemolytic Uremic Syndrome (HUS) ** Susan M. Fallone, MS, RN, CNN

* Discuss the pathophysiology of HUS.

* Identify treatment options and outcomes for HUS.

* Explore disaster planning options in managing an outbreak of HUS.

3:00 pro-4:00 pm Visit Exhibit Hall

4:00 pm-5:15 pm Concurrent Sessions Repeated

5:15 pm-6:30 pm Reception in Exhibit Bali


7:30 am-8:00 am Continental Breakfast

The Clinical Pathways and Vascular Access sessions will be repeated. The Transplant and Hemodialysis sessions are planned as one module in two 90-minute sessions and are not repeated (See explanation of “Essentials for Nephrology Nursing” on page 2).

8:00 am-9:30 am Clinical Pathways for Challenging Patients ** Karen Prussing, MS, CS, CNN, ANP

* List six categories of challenging patient situations faced by nephrology caregivers.

* Identify interventions that enable nephrology caregivers to care for challenging patients more effectively.

* Describe how to individualize a critical pathway for a specific patient care situation.

Vascular Access: Catheters ** Lesley C. Dinwiddie, MSN, RN, FNP, CNN

* Discuss the advantages and disadvantages of the types of central lines for dialysis access.

* List the “Dos and Don’ts” of catheter care.

* Identify assessment findings that indicate frequent problems that can occur with a vascular access catheter.

* Propose interventions that prevent vascular access catheter malfunction.

Essentials in Nephrology Nursing Module

The Renal Transplant Experience: A Case Study Approach ** Jean Colanari, MS, RN, CNN Clara D. Neyhart, BSN, RN, CNN

This program will explore the patient’s experience with renal transplantation. Using case studies, participants will discuss processes and protocols for transplant assessment, pre and post transplant nursing care, immunosuppression, and patient follow-up. The primary focus of the program is to strengthen the participant’s understanding of renal transplantation as a treatment modality for ESRD.

* Describe the components of the renal transplant process.

* Gather appropriate clinical assessment data related to each stage of the transplant process.

* Discuss current immunosuppression protocols including identification of side effects and nursing management.

* Evaluate the patient’s response to therapy based on outcome assessment.

Essentials in Nephrology Nursing Module

Response to Hemodialysis Therapy: Nursing Assessment and Intervention ** Carol Meers, BScN, RN, CNeph, (C) Patricia Baltz Salai MSN, RN, CNN

This program will explore the desired patient response to hemodialysis therapy, as well as interventions to achieve the desired response. Case studies will be analyzed to illustrate patient assessment principles, appropriate selection of a hemodialysis prescription, and prescription adjustment based on data from the on-going patient outcome assessment. Participants will have the opportunity to apply the program’s principles and concepts to situations in his/her own clinical practice.

* Describe the components of the HD prescription.

* Gather appropriate clinical assessment data related to the HD patient’s response to therapy.

* Recommend adjustments in the HD prescription based on clinical assessment data to achieve the desired patient response.

* Evaluate the HD patient’s overall response to therapies based on outcome assessment

9:30 am-10:00 am Break

10:00 am-11:30 am Clinical Pathways for Challenging Patients and Vascular Access: Catheters (Repeated) Essentials Modules will not be repeated

11:30 am-12:15 pm Box Lunch Provided

12:15 pm-1:15 pm The Power of Service In Health Care Petra Marquart, BA

This highly interactive afternoon will challenge us to think about the value and power of service. Each small group will examine one question about the expectations of service and report their insights back to the larger group.

* Explain the importance of the service perspective in health care.

* Identify the meaning of competition, expectation, technological changes, and health care change in relation to health care service.

* Discover the four cornerstones of extraordinary service: genuineness, congruency, paradigm, and attitude.

* Apply the principles of the Circles of Influence when providing service in the dialysis unit.

* Explore your emotional response to challenges of service.

1:15 pm-1:30 pm Break

1:30 pm-2:20 pm The Power of Service In Health Care (continued)

2:20 pm-2:35 pm Break

2:35 pm-4:00 pm The Power of Service In Health Care (continued)

** An application has been submitted to the Nephrology Nursing Certification Board to qualify these sessions for the fundamental nephrology nursing requirement that is necessary to take the CNN examination effective January 1, 2000. Separate documentation of your attendance at the designated sessions will be required.

COPYRIGHT 2000 Jannetti Publications, Inc.

COPYRIGHT 2007 Gale Group