Nursing Care and Postgraduate Education of Nephrology and Dialysis Nurses in Italy

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Marco Sguanci

DOI: 10.69097/41-05-2024-12

Stefano Mancin1,2, Federica Bragaglia2, Desirèe Andreoli3, Sara Morales Palomares4, Giovanni Cangelosi5, Marco Sguanci6, Maruska Bedin1, Lea Godino7, Cinzia Fabbri8, Domenica Gazineo9, Gaetano Ferrara10, Beatrice Mazzoleni2

1 IRCCS Humanitas Research Hospital, Rozzano, Italy
2 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
3 Azienda Ospedaliera Santa Maria della Misericordia, Perugia, Italy
4 Department of Pharmacy, Health and Nutritional Sciences (DFSSN), University of Calabria, Rende, Italy
5 Unit of Diabetology, ASUR Marche, Fermo, Italy
6 A.O. Polyclinic San Martino Hospital, Genova
7 Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
8 Nephrology, Dialysis, Hypertension Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
9 Governo clinico e qualità, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
10 Nephrology and Dialysis Unit, Ramazzini Hospital, Carpi, Italy

Corresponding author:
Dr. Marco Sguanci
A.O. Polyclinic San Martino Hospital,
Largo R. Benzi 10, 16132 Genova
E-mail: sguancim@gmail.com

 

Abstract

Introduction. Patients with chronic kidney disease undergoing renal replacement therapy have complex care needs. To address this, nephrology and dialysis nurses must possess expertise in advanced specialist and disciplinary skills. The aim of this review is to analyze post-graduate academic training pathways and clinical-care training in the field of nephrology and dialysis nursing in the Italian context.
Methodology. A narrative review of the literature was conducted in May 2024, using databases such as CINAHL and Medline-PubMed, with a selection criterion limited to primary and secondary studies published in Italian and English. To supplement the search, particularly within the Italian context, grey literature sources were consulted.
Results. Post-graduate nephrology nursing education in Italy is mainly offered through First-Level Masters, as well as Second Level Masters and specialization courses, which are provided at various academic institutions. Analysis of the educational programs revealed the presence of common “core” teachings across all pathways, covering renal disease pathophysiology, hemodialysis, peritoneal dialysis, and dialysis nursing care, alongside significant heterogeneity in other proposed teachings. Clinical-care training emerged as a fundamental aspect in both post-graduate education, professional integration for newcomers, and continuous professional development.
Conclusions. The growing healthcare need for specialist skills suggests the necessity of integrating field-based training with standardized post-graduate academic pathways, possibly in collaboration with relevant Nursing Scientific Societies. This synergy would not only promote the enhancement of nursing competencies but also ensure a high quality of care delivery.

Keywords: nephrology, dialysis, university education, postgraduate education

Introduction

Chronic Kidney Disease (CKD) has become an increasingly important clinical issue in contemporary healthcare due to its rising incidence and the inherent complexity of its management [1]. CKD is characterized by a progressive and irreversible loss of kidney function, which can develop over a long period, often without noticeable symptoms in the early stages [2]. The causes of CKD are multifactorial, including conditions such as hypertension [3], diabetes mellitus, cardiovascular diseases [4], polycystic kidney disease [5], and neoplasms [6]. Early diagnosis is crucial given the asymptomatic nature of the disease in its initial stages. However, diagnosis often occurs only when kidney function is significantly impaired, underscoring the importance of awareness campaigns and regular screenings, particularly in high-risk populations [7]. The management of CKD focuses on slowing its progression and addressing complications such as anemia, bone disorders, electrolyte imbalances, and metabolic acidosis, especially in its terminal stage, End-Stage Renal Disease (ESRD) [8].

Nephrology and dialysis specialist nurses not only provide specialized care during dialysis sessions, hospitalizations, and outpatient visits, but also operate within a complex care environment characterized by a significant degree of multi-morbidity in nephrology patients [9].

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