the future of renal nursing · standardizing education for future needs supporting higher education...

The Future of Renal Nursing

Patient Centered Care in the Digital Era

Marjelka Trkulja

Empowering renal nurses for the future

She started her carrier in 1993 as Renal Nurse in University Clinical Hospital Centre in Rijeka,

Croatia. From 2002 till 2008 she was mentor for haemodialysis part of the nursing education at

The School of Medicine in Rijeka.

From 2008 till 2017 was part of Fresenius Medical Care team in Croatia on the position of the

Country Nursing Manager, as well as EDTNA/ERCA Brand Ambassador for Croatia for 5 years.

She joint Fresenius Medical Care Management team in Bad Homburg as Head of Nursing Care in

2017.

RN, MSN, Director of Nursing Care

Marjelka Trkulja, Nursing Director

Prague, 15.09.2019

Empowering renal nurses for the future

Statistical facts 1

European health report 2018. More than numbers – evidence for all. Copenhagen: WHO Regional Office for Europe; 2018. Wan He, Daniel Goodkind, and Paul Kowal U.S. Census Bureau, International Population Reports, P95/16-1, An Aging World: 2015, U.S. Government Publishing Office, Washington, DC,2016 https://medium.com/the-mission/how-to-tackle-the-healthcare-worker-shortage-6e731db5c15d ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2016. Amsterdam UMC, location AMC, Department of Medical Informatics, Amsterdam, the Netherlands, 2018.

15/09/2019 EDTNA/ERCA CES© 2019 Fresenius Medical Care

Incidence of

patients over 75 y

p. million age related

population in EU

.

>1100

60,6

76,7 -77,9

74,0-75,6

71,7-74,6

Prevalence mean age

Life expectancy

general population

2010-2015

.

Patient survival

probability (%) 2 years

2010-2015

Incident dialysis

patients with

diabetes survival

probability(%)

2 years (2011-2014

2010-2015

Statistical facts 2


Population older

than 65

By 2050

16.7 percent of the world total

population

1,6 billion

33% increase

12,9 mil

1 in 4

The global

burden of NCDs

in people aged

60 and older

1990-2010

NCD: heart and lung

diseases, diabetes,

depression, and dementia,.

Global shortfall

of healthcare

workers

by 2035

World Health Organization

(WHO)

Population with

more chronic

health conditions

2012

CDC

Percent of people

over 65 who live

alone

2010-2016

29,9-30,9

European health report 2018. More than numbers – evidence for all. Copenhagen: WHO Regional Office for Europe; 2018. Wan He, Daniel Goodkind, and Paul Kowal U.S. Census Bureau, International Population Reports, P95/16-1, An Aging World: 2015, U.S. Government Publishing Office, Washington, DC,2016 https://medium.com/the-mission/how-to-tackle-the-healthcare-worker-shortage-6e731db5c15d ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2016. Amsterdam UMC, location AMC, Department of Medical Informatics, Amsterdam, the Netherlands, 2018.

Usual circle of illness at present


UNDER CONTROL

SYMPTOMS

RECOVERED

GP AND/OR HOSPITAL

HOME OUTSIDE

Long drive Waiting time

No/shortage of staff Equipment not working Nosocomial infections…

Need for Physiotherapy Antibiotic therapy

Pain Loneliness…

Illness

HOLISTIC PERSON

Physiotherapy

or other therapy

PEER

GROUP

Follow up

and recovery

CARE Visits

Health

education

Online peer

group

Nurse as

health coach or

case manager

App +

WebApp

Health

Tracking

Future circle of illness and change to person, not only patient

Health problem

Consultations

CARE Visits

Consultations

15/09/2019


Empowerment of the patients

Home Stakeholder Consultation

In-center Bystander

Order

Empowerment of the nurses


Dissatisfaction with nursing as a career

Leaving the job in the next year

Leaving reasons

Most often activities left undone

Replacement cost of each new nurse in 2007

What are we missing?

Nurses must stop 'eating their young’ and support their development!

25% 20-50%

Developing or updating nursing care plans (42%)

Comfort/ talk with patients (53%)

Educating patients and families (41%)

$82,000 to $88,000

poor nurse-physician relationships, poor leadership and burnout!

Eurohealth 2016; 22(1). Jones, C.B. (2008). Revisiting nurse turnover costs: Adjusting for inflation. Journal of Nursing Administration, 38(1), 11-18 https://www.nurseuncut.com.au/cne-nurses-must-stop-eating-their-young/


Institute of Medicine 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/12956.


Key recommendations

Nurses should practice to the

full extent of their education

and training

Nurses should achieve

higher levels of education

and training through an

improved education system

that promotes seamless

academic progression

Nurses should be full

partners, with physicians and

other health professionals, in

redesigning health care in

the United States

Effective workforce planning

and policy making require

better data collection and

an improved information

infrastructure

https://doi.org/10.17226/12956



Education and practice

Education and training

Need for qualified nurses to meet changing population needs, technology development and care models

standardizing education for future needs

supporting higher education and career development

evidence based practice, innovation and research

developing critical thinking skills to make complex clinical decisions

Institute of Medicine 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/12956. European strategic directions for strengthening nursing and midwifery towards Health 2020 goals

https://doi.org/10.17226/12956



Education and practice

Nursing Practice

Need to enable nurses to practice to the full extent of education and training

Regulations to enable practicing on highest education level

develop career paths as health coaches, nurse-led care clinics, system

innovators, nurse practitioners

engage in new paths in emerging fields like telehealth, informatics, and

genetics and genomics, and as scientists and leaders in society.


https://doi.org/10.17226/12956



Effective workforce, leadership and data collection

Effective workforce and positive work environment

Leadership opportunities that engage nurses to realize the full potential of nursing

workforce

Promote positive workforce planning and optimizing skill mix to provide safe

and effective care

Involving nurses in health-care industry strategy development and

deployment

Information infrastructure and data collection


https://doi.org/10.17226/12956



Partnering within Healthcare

Partnerships

Interdisciplinary and intersectoral collaboration for providing people-centred care and improved health outcomes.

Including nurses as effective members of the multidisciplinary team to:

Enable health systems to respond to changing demographics and burden of chronic

diseases,

Fully utilize current and future technologies,

Improve patient outcomes


https://doi.org/10.17226/12956

Start of dialysis as science

194

5

Management of the dialysis machine

1945 -

2005

Management of the dialysis patient

200

5-

201

9

Full Partnering in Management of care?

201

9-

203

0

Future direction in nursing?


Be an active driver of your own change and progress!

References

1. European health report 2018. More than numbers – evidence for all. Copenhagen: WHO Regional Office for Europe; 2018.

2. Wan He, Daniel Goodkind, and Paul Kowal U.S. Census Bureau, International Population Reports, P95/16-1, An Aging World: 2015, U.S. Government Publishing Office, Washington, DC,2016.

3. https://medium.com/the-mission/how-to-tackle-the-healthcare-worker-shortage-6e731db5c15d

4. Institute of Medicine 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/12956.

5. European strategic directions for strengthening nursing and midwifery towards Health 2020 goals

6. ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2016. Amsterdam UMC, location AMC, Department of Medical Informatics, Amsterdam, the Netherlands, 2018.

8. Eurohealth 2016; 22(1).

9. Jones, C.B. (2008). Revisiting nurse turnover costs: Adjusting for inflation. Journal of Nursing Administration, 38(1), 11-18


https://medium.com/the-mission/how-to-tackle-the-healthcare-worker-shortage-6e731db5c15d

















https://doi.org/10.17226/12956

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the future of renal nursing · standardizing education for future needs supporting higher education...

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