PubMed Health⌕ Search

Biomedical subjects

B Braj

Publications and source records attributed to B Braj.

5 recordsLinked to original sources
PubMed2000

Can the DOQI guidelines be met by peritoneal dialysis alone in pediatric patients? Dialysis Outcomes Quality Initiative.

DOQI guidelines recommend minimal standards for automated peritoneal dialysis (APD), with a weekly Kt/V of 2.1 and creatinine clearance (Ccr) of 63 l/1.73 m2. The purpose of this study was to assess if the DOQI guidelines could be met by dialysis alone in children on PD. Dialysis clearance studies were retrospectively analyzed in 20 pediatric patients on APD, all with a dwell volume of at least 1,000 ml/m2. Mean dialytic Kt/V was 2.0; only 45% had a Kt/V above the recommended 2.1. Mean dialytic Ccr was 43.5 l/week per 1.73 m2; only 10% achieved a Ccr above the recommended 63 l/week per 1.73 m2. Despite the significant correlation between total therapy volume (TTV) and both Kt/V and Ccr, only 2 of 10 patients with a TTV over 10 l/m2 per day reached the target Ccr. All patients had currently recommended dwell volumes, therapy times, and nocturnal cycles, but DOQI guidelines were difficult to achieve with dialysis alone. Strict adherence to DOQI guidelines in anephric pediatric PD patients may result in changing dialysis modality. However, without evidence of a correlation between delivered dose of dialysis and improved outcome, adequate dialysis should not be assessed by only measuring Kt/V and Ccr.

Canada↗
PubMed1999

The lived experience of adolescents who transfer from a pediatric to an adult hemodialysis centre.

The transition experience of adolescent patients who transfer from pediatric to adult hemodialysis centres has not received attention in the pediatric nephrology literature. In order for health care professionals from both pediatric and adult hemodialysis centres to positively influence the quality of life during this transition, an understanding of the meanings adolescents attach to their transition experience must be explored. Phenomenology as a research paradigm was employed for this study. Phenomenology provides a method from which to study human experience as it is lived, including the meanings that individuals attach to the experience. This qualitative research study was designed to describe the meanings adolescents attached to their transition experience. Subsequent objectives of the study were: to identify implications for professional practice in both pediatric and adult hemodialysis centres; to positively influence the quality of life for adolescent hemodialysis patients during their transition; and to identify and define potential areas for further research related to the holistic needs of adolescent hemodialysis patients. A sample of three English-speaking adults between the ages of 18 and 22 years who were receiving hemodialysis treatments in an adult centre following transfer from a pediatric centre within one year were interviewed. The tape-recorded interviews were transcribed into verbatim text. In addition, field notes provided investigators with the supplemental information about the meaning and the context of the interview that the audiotape may have missed. The data were analyzed using a step-by-step procedure adapted from Colaizzi (1978). In the final step, the investigators integrated and synthesized the analysis into a descriptive meaning of the transition experience of adolescents who transferred from a pediatric to an adult hemodialysis centre. The findings of the study revealed a major theme of ownership that the adolescents described as being achieved in the adult hemodialysis centre through their increased knowledge of dialysis technology, through being held accountable for their dialysis care and through increased feelings of independence.

Adaptation, Psychological↗
PubMed1996

The team approach to the management of children on chronic peritoneal dialysis.

The diagnosis of chronic renal failure has a profound and lasting impact on a child and family, with the potential for impairment of the child's physical, mental, and social development. To achieve an ideal outcome, the peritoneal dialysis (PD) team must focus on preparing the child and family to perform home dialysis, prescribe the dialysis regimen most compatible with the patient's lifestyle and clearance requirements, ensure optimal nutrition, and facilitate psychosocial adaptation to PD. Close follow-up is essential for early detection, prevention, and treatment of potential complications of dialysis. A multidisciplinary team approach encompassing nursing, medicine, nutrition, and social work best suits the needs of the child and family.

Child↗
PubMedDate not supplied

Development and application of a computerized workload measurement tool for nurse educators.

This paper describes the development and application of a computerized workload measurement tool for use in hospital nursing education departments. The tool was developed in response to a need to gather information to facilitate resource allocation within the nursing education department in times of severe fiscal constraint. Software was developed based on a commercially available spreadsheet to keep track of the time and nature of nursing educator activity as well as its location. Analysis of the results showed that most of the nurse educators' time was spent on educational activities. The workload measurement system provided useful information for both individual educators and for the department in assessing, planning and allocating resources for educators.

Education, Nursing, Continuing↗