The role of the pre-dialysis nurse in New Zealand

Background: International evidence suggests that pre-dialysis care is crucial for patients with chronic kidney disease (CKD). Pre-dialysis nurses play an important role in this care. Aim:This article describes and discusses the role of the pre-dialysis nurse in New Zealand (NZ). It presents findings front a larger qualitative study that explored what pre-dialysis nurses perceived to be effective care. Understanding their role was central to understanding effective practice. Methods: Semi-structured interviews were used to gain in depth data from eleven pre-dialysis nurse key informants from throughout NZ about their role. Confirmability of findings was strengthened by an additional group discussion with all participants. Thematic analysis guided by a general inductive approach was used to analyse data. Results: Five key themes emerged relating to the pre-dialysis nurse role: patient engagement and a holistic nursing assessment; the nurse as educator and support person; preventing complications; professional relationships and developing the role. The study illustrated the complexity and challenges that pre-dialysis nurse's encounter.There was some variation in roles and participants reported a lack of clear role definition. Conclusion: The findings highlighted a need for more standardised pre-dialysis nursing care in NZ, such as the implementation of guidelines for nurse patient ratios and the components of patient education. Although various guidelines exist, none of these are specific to the nurse's role and the implementation of nursing care. Implementation of NZ guidelines would not only provide clarity to pre-dialysis nurses but also ensure more equitable care of patients throughout NZ.