Examining the Role of the Registered Practical Nurses in Home Peritoneal Dialysis

Abstract

Purpose
This fellowship is focused on Home Health Nursing; it will concentrate on the growing population of clients with chronic kidney disease receiving home peritoneal dialysis.

This project has two aims:
• To increase knowledge about the autonomous and collaborative role of the Registered Practical Nurse(RPN) in the community setting, and subsequently create a decision making framework that will enable thoughtful decision making ; and
• The gain knowledge an expertise about the population of clients receiving home dialysis followed by the application of the decision making framework to define the RPN role within this client group.

Background
The trend toward home peritoneal dialysis as a safe and effective method of care delivery is increasing as institutional based peritoneal dialysis clinics reach capacity. A re-examination of the health care team currently composed primarily if Registered Nurses are necessary to ensure capacity to meet the future needs of this growing client group.

Method
I will gain knowledge regarding the utilization of the RPN through the process of creating a framework that will be used for decision making about the characteristics of community client populations appropriate for autonomous RPN practice. This will be done in consultation with my clinical mentor and nursing experts, including the College of Nurses on Ontario, (CNO). The framework will be built on the decision making factors published by the CNO. (CNO, 2006)

Building my clinical knowledge about clients receiving home peritoneal dialysis will be achieved through clinical placements, self-study, and internal certification. The decision making framework will then be used to identify the specific client, environmental, nursing, and treatment characteristics that define autonomous and collaborative RPN practice for this client group.

Project evaluation will be based upon achievement of personal learning, successful certification in peritoneal dialysis, completion of the decision making framework and its application to the population of clients receiving home peritoneal dialysis, Evaluation methods will include clinical mentor and preceptor feedback as well as self-reflection through journaling and discussion.

Anticipated Results
Knowledge and skill will be gained about how to define the RPN role within the community sector and in the area of caring for the client receiving home dialysis. The creation of a framework for decision making about autonomous RPN practice and its application to clients receiving home dialysis gained about the care and management of client receiving home peritoneal dialysis, this will allow me to expanded my clinical work to include this new client group.

Discussion/Conclusions
This project provides a phenomenal opportunity to thoughtfully define the role of the RPN with a new client population (clients receiving home peritoneal dialysis). As this population increased, other RPNs will be enables to become certified and take on this aspect of care. The outcomes of this fellowship will live well beyond it’s completion as Saint Elizabeth Health Care begins applying the decision making framework created to other client populations.

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