Barriers and Facilitators to Nurse Caring for Peritoneal Dialysis (PD) Patients in Rural Emergency Departments in Alberta

  • Author / Creator
    Lillebuen, Lisa
  • As dialysis numbers continue to grow, more Albertans are choosing peritoneal dialysis (PD) as their primary dialysis modality. Home dialysis therapies and especially PD are known to offer decided advantages and can offer patients greater autonomy and satisfaction with health care than in-facility dialysis.
    PD can be delivered almost anywhere, including in rural and remote locations and with the geographically diverse nature of Alberta many patients do not live near a center that offers PD. When complications arise, urgent treatment may be needed in a rural emergency department (ED). However, not all rural EDs are willing to provide this treatment. Problems can arise when patients have an issue that cannot be resolved over the phone and they need medical assistance.
    There is limited literature that looks at non-dialysis staff providing PD care to patients and most of it is in the context of home care support or long-term care centers. PD is considered a restricted activity by Alberta Health service and as such many nurses in rural communities do not feel comfortable or competent performing PD procedures on these patients. While some health professionals in rural areas have embraced the opportunity to learn PD procedures and have staff willing to assist patients when they present to their ED, other rural areas have staff not willing to do any PD related care even when taking direction over the phone from a PD trained nurse. Therefore, the purpose of this study was to identify the barriers and facilitators for rural emergency department nurses to provide PD care.
    An interpretive descriptive study was conducted at four sites across Northern Alberta with nurses who have either cared for a patient requiring PD or transferred a patient to another site to provide PD care. Semi-structured interviews were carried out with seven nurses. Themes that were found included education (along with the subtheme of resources), patient/family ability
    to perform PD, infrequent exposure, and physician supports. The findings from our study highlight the need for nurses working in these sites to be educated and have appropriate resources in order to care for these patients. PD programs will need to continue to provide high quality care, and ensure that patients and families have the competence to do PD.

  • Subjects / Keywords
  • Graduation date
    Fall 2019
  • Type of Item
  • Degree
    Master of Nursing
  • DOI
  • License
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