History_of_Nephrology_Nursing[PPT 11].pptx

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1. History of Nephrology Nursing Nephrology nursing focuses on caring for patients with kidney disease or undergoing kidney-related treatments like dialysis or transplantation. It has evolved alongside the development of renal medicine and the broader healthcare system, gaining prominence as chronic kidney disease (CKD) and dialysis treatments became more common.

2. An overview of the major milestones in the history of nephrology nursing Early Beginnings (Before 1950s)Ancient Times : The concept of kidney health is mentioned in early medical texts like those of Hippocrates, but treatments for kidney disease were extremely limited until the 20th century. Late 19th and Early 20th Centuries : The groundwork for nephrology began with the identification of kidney function and its connection to diseases . Nurses cared for patients with kidney disorders, but there were no specialized treatments.

3. The history of dialysis dates back to the 1940s. It started with recognition of kidney dysfunction and need to clean up the patients ’ blood . A Dutch physician Willem Kolff came up with idea of developing a machine to clean the blood after watching a patient suffer from kidney failure. He developed the dialyzer, then called it the artificial kidney, in 1943. He treated patients with acute kidney failure over the next two years with little success, he continued to experiment in improving his design. History of hemodialysis

4. Dr. Belding Scribner, a professor of medicine at the University of Washington, developed a way for ESRD patients to receive treatment through an access point in their arm. In 1962, Scribner opened the first official dialysis clinic for patients. He eventually developed a portable dialysis machine that allowed patients to receive dialysis treatment at home. By 1973, 40 percent of dialysis patients were doing their treatments at home. History of hemodialysis

5. An overview of the major milestones in the history of nephrology nursing 1950s: The Birth of Nephrology Nursing Development of Dialysis: Dr. Willem Kolff developed the first artificial kidney (dialysis machine) in 1943, and the first successful dialysis on a human patient occurred in the 1950s. As dialysis technology developed, the need for trained nurses to operate machines and care for patients undergoing dialysis grew. Establishment of the First Dialysis Units: Hospitals began establishing dialysis units in the 1950s, with nurses playing a crucial role in patient care, monitoring, and machine operation.

6. An overview of the major milestones in the history of nephrology nursing 1960s–1970s: Growth and Professionalization Chronic Dialysis Programs: Advances in dialysis technology allowed patients with end-stage renal disease (ESRD) to survive, creating a need for long-term dialysis programs. Nurses specializing in nephrology were essential in these settings, managing complex patient care. Development of Peritoneal Dialysis (PD ): Nurses were heavily involved in patient education and care for home-based peritoneal dialysis, allowing patients to manage their condition outside of hospitals. First Professional Organizations : The American Nephrology Nurses Association (ANNA) was founded in 1969, offering education, resources, and professional development for nephrology nurses.

7. An overview of the major milestones in the history of nephrology nursing 1980s–1990s: Expansion of Nephrology Nursing Roles Kidney Transplantation : As kidney transplantation became more successful, nurses expanded their roles in pre- and post-operative care, immunosuppressive therapies, and patient education. Nurse-Led Clinics: Nurses began leading CKD and dialysis clinics, managing not only dialysis care but also helping with lifestyle, nutrition, and disease management. Technological Advancements : Innovations in dialysis machines and treatment options increased the complexity of care, requiring nurses to continually update their knowledge and skills.

8. 2000s–Present: Modern Nephrology Nursing Multidisciplinary Care Teams : Nephrology nurses now work as part of multidisciplinary teams alongside physicians, dietitians, social workers, and other healthcare professionals, coordinating comprehensive care for kidney patients. Telemedicine and Home Dialysis : The rise of telehealth and remote monitoring for dialysis has expanded the role of nephrology nurses in overseeing home dialysis treatments and using technology to provide patient care. Advances in Patient Education : Nephrology nurses play a vital role in patient education, especially for those with CKD, focusing on lifestyle changes, medication management, and preventing further kidney damage.

9. Key Contributions of Nephrology Nurses Dialysis Care: Nephrology nurses manage hemodialysis and peritoneal dialysis procedures, monitor patient conditions, and ensure the safe use of dialysis equipment. Transplant Care: They are involved in pre- and post-transplant patient care, providing education on medications, lifestyle changes, and potential complications. Chronic Kidney Disease (CKD) Management: Nurses educate patients about disease progression, dietary and lifestyle modifications, and treatment adherence to slow the progression of CKD. Leadership Roles: Nephrology nurses have assumed leadership roles in research, clinical practice, and policy-making to improve kidney health worldwide.

10. Global Impact Nephrology Nursing Worldwide: Organizations like the International Society of Nephrology (ISN) promote global initiatives to improve kidney care, especially in developing countries. Nurses play an essential role in these efforts, as they are often the primary healthcare providers for patients with kidney disease in resource-limited settings.

11. Nephrology Nursing in Africa Early Beginnings (Pre-1980s) Limited Access to Kidney Care : Prior to the 1980s, nephrology care across most African nations was minimal. Dialysis services and kidney transplant programs were rare, mostly available in major cities or specific countries like Egypt and South Africa, where healthcare infrastructure was more advanced. General Nursing Practice : In the early years, there were no formal training programs for nephrology nursing. General nurses working in hospitals would be tasked with caring for patients with kidney disease, but there was no specialized focus or training. Kidney diseases were often underdiagnosed, and treatment options were limited.

12. Introduction of Dialysis (1980s-1990s Introduction of Dialysis in Select Countries : During the 1980s and 1990s, countries like Egypt, South Africa, Nigeria, and Kenya began introducing dialysis centers in response to the rising burden of chronic kidney disease (CKD). Dialysis technology was expensive, and services were limited to a few urban hospitals. Early Nephrology Nursing Pioneers : In these early days, nephrology nurses were often trained on the job or through collaborations with international organizations. There were no formalized nephrology nursing programs, and nurses typically received ad hoc training to operate dialysis machines and manage the care of patients undergoing dialysis.

13. Introduction of Dialysis (1980s-1990s South Africa's Early Role: South Africa, in particular, became a leader in kidney transplantation on the continent during this period. With the first successful kidney transplant in 1966, South Africa became one of the few African countries where nephrology care advanced rapidly Specialized nephrology nurses played key roles in the care of patients undergoing dialysis and kidney transplants, and this experience contributed to the growth of the profession.

14. 1962 to 1963 , both peritoneal dialysis (PD) and hemodialysis were used routinely for the management of acute renal failure and poisoning in Cairo and Johannesburg university hospitals. Two North African universities in Tunisia and Algeria and In Kenya dialysis services were started in 1978 mainly peritoneal dialysis and Hemodialysis was officially started at KNH in 1984. History of Hemodialysis in Africa

15. Growth and Formalization of Nephrology Nursing (2000s ) Rising CKD Burden : The incidence of CKD in Africa increased significantly in the 2000s due to factors like hypertension, diabetes, HIV-related kidney disease, and untreated infections. This rising burden led to a greater demand for dialysis services and, consequently, specialized nephrology nurses. Establishment of Nephrology Nursing Associations : Around this time, professional organizations like the African Nephrology Nursing Association (AFNAN) These bodies focused on promoting professional development, advocating for better resources, and standardizing nephrology nursing practices across Africa.

16. Nephrology Nursing in Africa The field of nephrology in Africa began to gain recognition in the late 20th century. The African Association of Nephrology (AFRAN) was established in 1987 during the first International Society of Nephrology-sponsored conference in Cairo1. This marked a significant step in organizing and advancing nephrology care across the continent. Key Milestones • 1980s: The establishment of AFRAN helped unify nephrology efforts across Africa, promoting research, education, and clinical practice improvements. • 2000s: The burden of kidney diseases, both chronic and acute, became more apparent, leading to increased efforts in training and resource allocation1. • 2020 : The COVID-19 pandemic highlighted the vulnerabilities in healthcare systems, including nephrology, but also spurred innovations and collaborations1

17. African Nephrology Nursing Association (AFNAN) The African Nephrology Nursing Association (AFNAN) is a regional body that unites nephrology nurses across Africa, including Kenya, with the goal of advancing nephrology nursing practice and improving patient outcomes for those affected by kidney disease across the continent AFNAN organizes conferences, webinars, and training sessions where nephrology nurses from Kenya can learn about the latest developments in kidney care, dialysis technology, and transplant management from international experts. Standardization of Nephrology Nursing Practice : AFNAN works to standardize nephrology nursing practices across the continent. By creating guidelines, protocols, and frameworks, the association ensures that nurses, including those in Kenya, adhere to internationally accepted standards of nephrology care.

18. Evolution of Nephrology Nursing in Kenya Nephrology nursing in Kenya has developed in response to the growing burden of chronic kidney disease (CKD) and the increasing need for dialysis and kidney transplants. While the evolution of nephrology nursing in Kenya mirrors global trends, its unique trajectory is shaped by the country's healthcare infrastructure, challenges in resource availability, and the expanding role of trained professionals in nephrology care.

19. Early Development (Pre-2000s) Limited Access to Specialized Care : In the early years, Kenya had very few specialized nephrology units, and kidney-related diseases were managed primarily in general medical wards. There were minimal resources for dialysis, and patients with advanced kidney disease had limited options. Initial Dialysis Centers : Hemodialysis was introduced in a few urban hospitals, such as Kenyatta National Hospital (KNH) in Nairobi in the year 1984, but services were expensive and scarce. Nephrology nursing was not yet a formal specialty, and nurses involved in dialysis were general medical-surgical nurses trained on the job

20. 2000s: Expanding Access and the Birth of Nephrology Nursing Increase in CKD Cases : By the early 2000s, there was a rising incidence of CKD in Kenya, largely driven by increasing rates of hypertension, diabetes, and other non-communicable diseases. This led to a growing demand for specialized kidney care. Introduction of Nephrology Nursing Training : Recognizing the need for skilled professionals to manage dialysis and kidney patients, Kenya began developing nephrology nursing programs. Kenyatta National Hospital played a key role in offering training for nurses in managing dialysis machines and caring for kidney patients

21. 2010s: Major Developments in Nephrology Nursing Government Efforts to Improve Access to Dialysis : In 2013, the Kenyan government launched a National Renal Program aimed at increasing access to dialysis services across the country. Public hospitals were equipped with dialysis machines, and nephrology nursing became an increasingly important specialization. Increased Training Programs : Nursing schools began to offer nephrology nursing as part of their postgraduate specialty programs. Key institutions like the University of Nairobi and Kenya Medical Training College (KMTC) developed courses to train nephrology nurses in managing both hemodialysis and peritoneal dialysis.

22. Late 2010s to Present Expansion and Continued Growth of Dialysis Services : By the late 2010s, more than 50 dialysis centers had been established in public and private hospitals across Kenya, particularly in urban areas. Nephrology nurses were crucial to the expansion of these services, providing hands-on patient care, monitoring, and education. Public-Private Partnerships : The government collaborated with private health organizations to scale up dialysis access, leading to further demand for trained nephrology nurse

23. Public-Private Partnerships In Kenya, nephrology nursing has seen substantial growth, particularly with the establishment of specialized training programs. The East African Kidney Institute (EAKI) offers a Masters degree and Higher Diploma in Renal Nursing, and in which is a significant step in professionalizing and enhancing the skills of nurses in this field Kidney Transplant Programs : Along with dialysis, kidney transplants became an option for patients with end-stage renal disease (ESRD) in Kenya. Nurses were trained in pre- and post-operative care for transplant patients, including immunosuppressive therapy management and patient educatio

24. Late 2010s to Present The Nursing Council of Kenya (NCK) has played a foundational role in the development of nephrology nursing by standardizing education, ensuring quality and ethical practice, promoting professional development, and advocating for policies that enhance the working conditions of nephrology nurses . Through its regulatory and developmental efforts, the NCK has been instrumental in advancing nephrology nursing, ultimately improving the quality of care for kidney patients across Kenya

25. Development of Professional associations The Kenya Nephrology Nurses Association (KNNA) is a key professional body that has significantly contributed to the advancement of nephrology nursing in Kenya. Since its inception, KNNA has focused on improving the standards of care for patients with kidney disease and enhancing the professional development of nephrology nurses. Professional Development and Training : KNNA has played a crucial role in establishing continuous professional development (CPD) programs for nephrology nurses. Through workshops, seminars, and training sessions, the association ensures that nephrology nurses are equipped with the latest knowledge and skills in dialysis care, transplant nursing, and general kidney disease management.

26. Advocacy and Policy Influence : KNNA advocates for better working conditions, resources, and compensation for nephrology nurses in Kenya. They work with government bodies and healthcare providers to address issues such as the shortage of dialysis centers, lack of equipment, and nurse-to-patient ratios. KNNA has been instrumental in pushing for the inclusion of renal care services in the National Hospital Insurance Fund (NHIF) , ensuring that more Kenyans have access to subsidized dialysis and kidney transplant services.

27. Patient Education and Awareness Campaigns KNNA is involved in organizing public awareness campaigns about chronic kidney disease (CKD), early detection, and prevention. By educating the public, the association helps reduce the incidence of CKD and encourages early intervention, which can prevent the progression to end-stage renal disease (ESRD). KNNA collaborates with the Kenya Renal Association (KRA) to host World Kidney Day events, which focus on promoting kidney health awareness and the importance of preventive care

28. Mentorship and Leadership Development: Through mentorship programs, KNNA supports the growth of young nephrology nurses, fostering leadership skills and encouraging participation in research, innovation, and policy-making in the field of nephrology nursing. Research and Evidence-Based Practice KNNA encourages and supports research initiatives within nephrology nursing. By promoting a culture of evidence-based practice, the association helps to advance nephrology nursing care through innovations, improved patient outcomes, and the adoption of new treatment protocols.

29. Challenges in Nephrology Nursing Limited Training and Workforce : Despite growth, there are still not enough nephrology nurses to meet the increasing demand for kidney care in Kenya. Training programs remain concentrated in urban areas, and rural parts of the country still face a shortage of specialized nurses. Resource Constraints : Many dialysis centers face resource constraints, including a lack of modern equipment and sufficient staffing. Nephrology nurses often work in challenging conditions with limited support. Patient Burden : The cost of kidney care, especially dialysis, remains high for many Kenyans, despite government subsidies. Nephrology nurses often help patients navigate these financial barriers and provide guidance on lifestyle changes and home care

30. Future Perspectives in Nephrology Nursing in Kenya Advancing Nephrology Nursing Education : To meet the rising burden of kidney disease, Kenya is investing in expanding its nephrology nursing programs. Efforts are being made to establish more formalized training and certification programs, often in collaboration with international nephrology organizations. Role in Preventive Care: Nephrology nurses are increasingly involved in preventive kidney care, including early detection of CKD, patient education on lifestyle management, and promoting health awareness about kidney disease prevention, particularly in underserved areas. Telemedicine and Home Dialysis : The future of nephrology nursing in Kenya may also involve greater use of telemedicine and home dialysis programs, where nephrology nurses will play a vital role in supporting patients remotely and ensuring continuity of care in rural areas.

31. References Evolution of Nephrology Nursing as Reflected in the Early Nursing Literature - PubMed (nih.gov) Oxford handbook of dialysis b Jeremy levy and Edith Handbook for dialysis by Dr Abdulla, A M Khader and edddith emedicine.medscape.com