The Role of Nursing in Improving Patient Outcomes in Hemodialysis: A Focus on Patient Education, Adherance, and Complication Management

Abstract

Hemodialysis is the cornerstone of renal replacement therapy for patients with end-stage renal disease (ESRD),
which is defined as irreversible loss of kidney function. Developments in dialysis technology have helped make
treatment accessible and improved survival, but outcomes for this hemodialysis treatment remain reliant overall on
the delivery of high-quality multidisciplinary care, of which nursing care is a key component. Nurses in hemodialysis
units perform both technical procedures as well as functions as educators, outcome facilitators, and first responders
to treatment complications. They have the most contact with patients, hence best placed to identify psychosocial
barriers, support health education, monitor clinical signs and intervene rapidly in case of emergencies. Abstract: We
present a narrative review of key areas in hemodialysis care that highlight the contribution of nurses to improving
patient outcomes, specifically in the areas of (1) patient education, (2) adherence to dialysis regimens and (3)
complications. The effectiveness of nurse-led interventions on reducing the incidence of CNE is illustrated with a
relevant, real-world case example, and the specific outcomes associated with nursing care are summarized in a table
format. In addition, a conceptual flow sheet represents the variability in nursing functions throughout the dialysis
care trajectory, specifying the holistic and proactive role of nephrology nurses. These findings underline the necessity
of ongoing resources toward nursing training, staffing, and infrastructures to ensure the quality of care—and the
long-term future—of dialysis patients