Nursing procedures during continuous renal replacement therapies: a national survey.
BACKGROUND
The current role of nurses in the management of critically ill patients needing continuous renal replacement therapies is clearly fundamental. The care of these complex patients is typically shared by critical care and dialysis nurses: their precise duties may vary from country to country.


METHODS
To clarify this issue we conducted a national-level survey at a recent Italian course on nursing practices during continuous renal replacement therapies.


RESULTS
A total of 119 questionnaires were analysed. The participants, who were equally divided between critical care and dialysis nurses, came from 44 different hospitals and 35 Italian cities. Overall, 23% of participants answered that "the dialysis staff" were responsible for continuous renal replacement therapies in the Intensive Care Unit, while 39% answered "the critical care nurse", and 38% "a shared organization". Interestingly, less than the half of participants claimed specific continuous renal replacement therapies training was provided to employees before handling an acute dialysis machine. Finally, about 60% of participants had experience of extra-corporeal membrane oxygenation machines used in conjunction with continuous renal replacement therapies.


CONCLUSIONS
Workload coordination and management of critically ill patients undergoing continuous renal replacement therapies in Italy is not standardized. At present, the duties of critical care and dialysis nurses vary significantly across the country. They frequently overlap or leave gaps in the assistance received by patients. The role of nurses involved in the care of continuous renal replacement therapies patients in Italy currently requires better organization, possibly starting with intensive standardized training and educational programs.
Pediatric Cardiac Intensive Care Unit, Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Zaccaria
Z
Ricci
Pediatric Cardiac Intensive Care Unit, Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Sonia
S
Benelli
Department of Nephrology, Dialysis and Transplantation, S. Bortolo Hospital, Vicenza, Italy ; International Renal Research Institute, Vicenza, Italy.
Fabio
F
Barbarigo
Vicenza Nurse Practices Survey Working Group, Vicenza, Italy.
Giulia
G
Cocozza
Pediatric Cardiac Intensive Care Unit, Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy ; Vicenza Nurse Practices Survey Working Group, Vicenza, Italy.
Noemi
N
Pettinelli
Pediatric Cardiac Intensive Care Unit, Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy ; Vicenza Nurse Practices Survey Working Group, Vicenza, Italy.
Emanuela
E
Di Luca
Department of Nephrology, Dialysis and Transplantation, S. Bortolo Hospital, Vicenza, Italy ; Vicenza Nurse Practices Survey Working Group, Vicenza, Italy.
Mariangela
M
Mettifogo
Department of Nephrology, Dialysis and Transplantation, S. Bortolo Hospital, Vicenza, Italy ; Vicenza Nurse Practices Survey Working Group, Vicenza, Italy.
Andrea
A
Toniolo
Department of Nephrology, Dialysis and Transplantation, S. Bortolo Hospital, Vicenza, Italy ; International Renal Research Institute, Vicenza, Italy ; Vicenza Nurse Practices Survey Working Group, Vicenza, Italy.
Claudio
C
Ronco
continuous renal replacement therapy; extracorporeal membrane oxygenation; simulation; survey; training