Hospital Leader and Nurse Practitioner Tips for Achieving NP Role Value – Christina (Tina) Hurlock-Chorostecki PhD, NP-Adult and Janice McCallum
Please use the following link to watch the session: https://youtu.be/rT4h3DBqR-Y
Hospital leaders tell us they have little information that clearly explains nurse practitioner role value. Hence nurse practitioner roles are commonly integrated without achieving the optimal practice and quality outcomes envisioned. We will present new strategies for hospital leaders, nurse practitioners, and other team members that support successful nurse practitioner role value optimization.
Participants will learn these key messages:
1. NP practice is optimal when enacting all three (3) practice foci.
2. NP practice is optimized through recognition and support of ‘invisible work’ and authorized clinical activities, enabling NP role flexibility, and building trust.
3. Optimal NP practice benefits: patients, healthcare organizations, team cohesion, professional capacity, and the healthcare system.
Hypertension in Hemodialysis – by Dr. Robert Richardson MD FRCPC
Please use the following link to watch the session: http://www.anymeeting.com/elvmrllsny/E954DE8982493F
If the HD patient had a 2-3 litre intradialytic weight gain, could not tolerate a UFR above 700ml/HR and still had a systolic blood pressure throughout HD treatment of 180-230mmHg, what could decrease the blood pressure safely? The patient is scheduled HD treatments four times per week for 4hr sessions. BP medications are ordered but blood pressure remains elevated.
Patients with excessive interdialytic weight gain can be a major problem. The first thing to do is compare their typical predialysis serum sodium concentration to their dialysate sodium concentration and make sure that the dialysate sodium concentration is at or below the serum sodium concentration. If the dialysate sodium is too high, reducing it can reduce interdialytic weight gain. Second I would like to know why the patient can’t tolerate fluid removal – is it because of low blood volume or perhaps cramping with blood volume change that is not very large. Some patients cramp independent of blood volume change and this can limit ultrafilatration. These patients may benefit from sodium ramping – high to low, but making sure that the time-averaged dialysate sodium equals predialysis serum sodium. Having a dietician review sodium in the diet may be very helpful – gaining 3 L between treatments while on 4 times a week dialysis suggests very high salt intake.