Background Laughter Yoga is a patient engagement strategy that promotes health and wellbeing through a structured group laughter therapy program or session. It is a cost-effective and accessible exercise that has been shown to improve mood, and reduce both stress and anxiety.
Method The aim of this project was to evaluate the effectiveness of Laughter Yoga in improving wellbeing, in a cohort of people with kidney disease requiring haemodialysis. The study aimed to see an improvement in patient wellbeing. Wellbeing areas under consideration were general satisfaction with life and health, general feelings impacting on wellbeing, expectations in life, chronic pain and ability to relax/wind down. Sixteen patients on thrice-weekly haemodialysis participated in a weekly Laughter Yoga therapy session for four weeks.
Results The intervention was evaluated using a non-validated pre- and post-survey. The survey showed the positive indicators for wellbeing increased. The general overall satisfaction with life and health perceptions saw an increase of the mean score from 6 to 7.8 and 4.7 to 6.8, respectively. The positive feelings that participants were asked to comment on revealed a mean score increase. The more challenging feelings that impact on wellbeing showed a mean score decrease. The questions completed about life expectations observed smaller mean score increases. Participants' scores on difficultly to wind down, difficulty with being able to relax and levels of chronic pain showed a mean score decrease.
Conclusion The patients that engaged found Laughter Yoga to be a value-adding activity that supported their wellbeing.
ContextThe latest KHA-CARI guidelines provide recommendations on screening for and management of blood-borne viruses (BBV) and multi-resistant organisms (MRO). The Guidelines comprise almost 80 pages, and include detailed practical advice related to clinical infection prevention, management considerations, and the working party’s evidence sourcing methodologies.
Objectives To outline the format and content of the guidelines, summarising key points as relevant to nursing practice within haemodialysis units. To review the key points in the guidelines in regard to standard precautions, routine and enhanced surveillance screening, management of patients with positive results for BBV and MRO, environmental and equipment use and cleaning, use of personal protective equipment, and suggestions for clinical care. To highlight how the guidelines can support a dialysis unit in meeting relevant standards in the accreditation process.
Key findings The KHA-CARI guidelines governing infection control in Australian and New Zealand haemodialysis units are detailed and evidence-based, and if adopted within an appropriate clinical governance framework, provide a comprehensive approach toward unit-based infection control that supports compliance with a number of the eight Australian National Safety and Quality Health Service (NSQHS) standards.
Patient-centred care and implementation impact is a key focus of the guidelines, although they highlight limitations imposed by gaps in evidential knowledge.
Conclusion The KHA-CARI infection control guidelines provide a high-quality, evidence-focused and detailed review of recommendations in regard to preventing and managing BBV and MRO infections in dialysis units. They align with NSQHS accreditation standards.
Aim To review the effects of bioimpedance spectroscopy (BIS) to measure dry weight (DW) in haemodialysis (HD)patients when compared to clinical examination.
Methods The review was conducted according to the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MasARI). Meta-analysis was performed using Review Manager 5 software. The search was limited to English language papers published from 2005 to 2017. A standard JBI three-step search strategy was used. We searched all quantitative studies from major databases for investigations of the BIS for measuring DW in HD patients.
Results A total of four randomised controlled trials (RCTs) met the inclusion criteria. These studies all involved patients with end-stage kidney disease (ESKD) receiving HD and the comparison of BIS versus physician’s clinical judgement using cardiovascular parameters and mortality outcomes. The meta-analysis of BIS when compared with clinical judgement found no significant differences in the reduction of the mortality rate, hospitalisation rate or other cardiovascular parameters after 12 months of the intervention; only significant improvement in pre-dialysis systolic BP (WMD –5.41, 95% CI –9.00 to –1.82; p=0.003) was reported. However, individual RCTs found that BIS is an effective intervention for HD patients in the reduction of the mortality rate (HR 0.100, 95% CI, 0.013 to 0.805; p=0.04) after 2.5 years of the intervention.
Conclusion The small number of participants and restricted participant selection criteria all has considerable impact with regard to generalising these findings to wider HD populations.
Aim The aim of this study was to critically review research literature investigating the role of practice nurses in the early identification and management of chronic kidney disease (CKD) in the general practice setting.
Method An integrative review was performed to determine the extent to which the topic has been investigated. Quantitative and qualitative research papers were systematically located in peer-reviewed journals in electronic databases. Included papers were critically appraised using the relevant CASP appraisal tools.
Findings There is a paucity of research investigating the role of practice nurses in the early identification and management of CKD in primary health care. Three articles published between 2013 and 2017 were identified: two quantitative studies and one qualitative study. One study from The Netherlands quantified positive outcomes of practice nurse-centred management of CKD in general practice.
Conclusion Practice nurses may be effective in the early identification and management of CKD, including improving blood pressure control. Providing education to practice nurses appears to be a key factor in increasing practice nurses’ involvement in identification and management of CKD. Further research is warranted to see if the results are transferable to other jurisdictions.