The Effect of the Advanced Nursing Practice Addressed by Clinical Guidelines on the Quality of Life of Elderly Patients with End Stage Renal Disease on Hemodialysis Treatment

Monday, July 11, 2011

Nancy Griselda Perez Briones, BS
María de los Ángeles Villarreal Reyna, PhD
Ana Laura Carrillo Cervantes, RN
María Magdalena Delabra Salinas, RN
School of Nursing, Universidad Autónoma de Coahuila, Saltillo, Coah, Mexico

Learning Objective 1: The learner will be able to describe how elderly patients with ESRD on HD treatment are limited by restrictions that affect their quality of life.

Learning Objective 2: The learner will be able to describe how Mexican nurses discuss the use of standardized clinical guidelines in the advanced nursing practice.

Purpose: To test the effect of the advanced nursing practice addressed by standardized clinical guidelines in the quality of life of elderly people with End Stage Renal Disease (ESRD) on Hemodialysis treatment (HD).

Methods: Repeated measures quasi-experimental design with two different groups: experimental group (n = 25) will receive standard care for ESRD based on disease-specific guidelines and control group (n=25) will receive the traditional care for ESRD. The sample size is estimated using ANOVA for repeated measurements with three levels (level of confidence 95%, power = .90) for the interaction time per group, and a large effect size (Lipsey, 1990). The nQuery Advisor 7.0 software is used (Elashoff, 2007) The following variables will be made using standardized assessments: pain (McGill Pain Questionnaire–Short Form, 2009), fatigue (Brief Fatigue Inventory, 2006), depression (Patient Health Questionnaire, 2005), cognitive impairment (Mini Mental State Exam, 2000), impaired physical performance (Short Physical Performance Battery, 2006) and quality of life (Kidney Disease Quality of Life, 2005). Outcome measurements will be performed at: baseline, end of the experimental condition and following. The study will be conducted at the Hospitals Christus Muguerza in Monterrey, Nuevo León city, and Saltillo, Coahuila city, between January and December 2011.

Results: A repeated measures ANOVA will be used for each outcome variable and post hoc analysis to determine group differences.

Conclusion: We will discuss the effect of nursing practice addressed by clinical guidelines based on the scientific evidence available in the advanced nursing practice on the quality of life of elderly patients with ESRD on HD.