Development of an educational resource for dialysis nurses about pediatric hemodialysis

Abstract

Background: Hemodialysis (HD) is a form of renal replacement therapy used for the treatment of kidney disease. In Newfoundland and Labrador (NL), there is a high incidence rate of HD use among the adult population compared to other Canadian provinces; however, the incidence of HD use in the pediatric population is historically rare. The recent rise in multi-organ inflammatory syndrome in children (MIS-C) secondary to COVID-19, combined with the unpredictable weather preventing patient transfer to larger pediatric hospitals elsewhere in Canada, has led to an increased requirement for pediatric HD use in NL. There are no policies or educational resources for nurses specific to pediatric HD in NL. Purpose: To develop an educational resource for nurses that will improve their knowledge and skills to perform HD on pediatric patients in NL and, ultimately, improve patient and family outcomes. Methods: I completed an integrative literature review, followed by consultations with local field experts including eight nurses, the clinical educator of the Dialysis Program at Eastern Health, and two nephrologists. I completed an environmental scan with the HD Program Coordinator at a pediatric hospital in Ontario. Based on the information obtained, I developed an education module. Results: Through literature review, consultations, and environmental scan, I determined the content and delivery method(s) for the educational resource. The content included the lived experience of the patient/family and nurse, nursing care of a pediatric patient and family, vascular access with infection prevention, fluid and volume removal, vital sign ranges, dialysis prescription, machine set-up and programming, and nursing assessment. The most frequently cited education delivery methods in the literature were lecture, simulation, hard-copy, and online module. The most frequently identified delivery methods through the consultations and environmental scan were online module, simulation, and hard-copy. As such, I chose an online module and a hard copy. Conclusion: The online module will be available on LEARN, the Eastern Health online education platform, once approved. A hard copy will be available in the dialysis unit at the Health Sciences Centre in Eastern Health. The educational resource with all components will aid in improving nurses’ competency to perform pediatric HD, thereby improving patient and family outcomes.