Key result
Home dialysis nurses were significantly more likely than in-center hemodialysis nurses to perceive that in-center hemodialysis is over-utilized (85% vs 58%, p=0.024) and to prefer home modalities for complex patients.
Cross-Sectional (n=89)
No
Absolute Event Rate: 85% vs 58%
p-value: p=0.024
Dialysis nurses' views on modality selection are strongly influenced by their specific area of clinical experience and expertise.
Nurse perceptions of modality suitability differ by practice setting; hypothesis-generating for experience-driven bias and requires prospective validation before informing counseling.
BACKGROUND: There is a paucity of information about the views of dialysis nurses towards dialysis modality selection, yet nurses often have the most direct contact time with patients. We conducted a survey to better understand nurses' attitudes and perceptions, and hypothesized that nurses with different areas of expertise would have differences in opinions. METHODS: We administered an electronic survey to all dialysis/predialysis nurses (n = 129) at a large, tertiary care center. The survey included questions about preferred therapy - in-center hemodialysis (CHD), versus home dialysis (home hemodialysis and peritoneal dialysis) and ideal modality mix. Responses were compared between nurses with home dialysis and CHD experience. RESULTS: The survey response rate was 69%. Both nursing groups ranked patient caregivers and dialysis nurses as having the least impact on patient modality selection. For most patient characteristics (including age > 70 years and presence of multiple chronic illnesses), CHD nurses felt that CHD was somewhat or strongly preferred, while home dialysis nurses preferred a home modality (p < 0.001 for all characteristics studied). Similar differences in responses were noted for patient/system factors such as patient survival, cost to patients and nursing job security. Compared to CHD nurses, a higher proportion of home dialysis nurses felt that CHD was over-utilized (85% versus 58%, p = 0.024). CONCLUSION: Dialysis nurses have prevailing views about modality selection that are strongly determined by their area of experience and expertise.
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Tennankore et al. (2013) conducted a cross-sectional in Nephrology nurses' attitudes towards dialysis modality selection (n=89). Home dialysis nursing expertise vs. In-center hemodialysis (CHD) nursing expertise was evaluated on Perception that the ideal proportion of patients receiving in-center hemodialysis (CHD) should be lower than current perceived proportions (p=0.024). Home dialysis nurses were significantly more likely than in-center hemodialysis nurses to perceive that in-center hemodialysis is over-utilized (85% vs 58%, p=0.024) and to prefer home modalities for complex patients.
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