ASSESSMENT OF KNOWLEDGE AND PRACTICE OF NURSES REGARDING HEMODIALYSIS AND RELATED COMPLICATIONS AT SELECTED GOVERNMENTAL IN ADDIS ABABA, ETHIOPIA, 2020

ADDIS ABABA UNIVERISTYCOLLEGE OF HEALTH SCIENCESSCHOOL OF NURSING AND MIDWIFERYASSESSMENT OF KNOWLEDGE AND PRACTICE OF NURSES REGARDING HEMODIALYSIS AND RELATED COMPLICATIONS AT SELECTED GOVERNMENTAL IN ADDIS ABABA, ETHIOPIA, 2020BY; TEMESGEN LEGESSE AYELE ID GSR/5043/11 ADVISOR; ZURIASH M. (PHD STUDENT) CO-ADVISOR: WUDMA A. (PHD STUDENT)1. Introduction1.1 Background Our kidneys perform several functions in order to maintain balance fluid and electrolyte in our bodies. They filter waste products and excrete them in the urine. They adjust the amounts of water and electrolytes like sodium, potassium and calcium in the body (Hinkle & Cheever, n.d.2018). Chronic kidney disease (CKD) is a progressive loss of renal function over a period of months or years. Severe CKD requires renal replacement therapy. This may be in the form of dialysis, and renal transplantation (Takagi, 2014).Hemodialysis (HD) is an extracorporeal therapy that is prescribes to reduce the signs and symptoms of uremia and to partial replace of the key functions of the kidneys when kidney function is no longer sufficient to maintain an individual’s well-being or life (Gilbert, Weiner, Gipson, & Arbor, n.d.2014). It involves bidirectional movement of molecules across a semipermeable membrane. Clinically, this movement takes place in and out of blood, across a semipermeable membrane (Ahmad, 2009). Hemodialysis (HD) is one of the important modalities of renal replacement therapy in acute renal failure (ARF) as well as chronic renal failure (CRF). Hemodialysis (HD) is one of life-saving treatment modality that has routinely applied for end-stage renal disease (ESRD) (Singh, Singh, Rathore, & Choudhary, 2015). Hemodialysis (HD) has existed for more than 50 years and has extended the lives of millions of patients with renal failure worldwide. Although the basic principles of HD are still applying today, dialysis technology has improved markedly ( John Feehally, Jürgen Floege, Marcello Tonelli, Richard J. Johnson (2019).Despite the many technical advances in medical care and dialysis delivery that over the last few years, mortality and morbidity rates remain high and the quality of life of uremic patient is still poor (Sirisan, Pattarajinda, Vichitphan, & Leesing, 2013). The patient and the dialysis apparatus are under supervision of nurses consistently, so that different potential complications can detect. Nurses must have knowledge and skills, because they considered important features of quality nursing care in the hemodialysis treatment (Sirisan et al., 2013).Although technical advances in hemodialysis (HD) have made the procedure increasingly safe and well tolerated, but there are still important acute complications that had encountered by nurses responsible for patients receiving HD in both acute and chronic clinical settings.Generally, Complications of hemodialysis can be divide into two major groups: Treatment-related medical complications: Those are frequent intradialytic complications, these (in order of frequency) include hypotension, muscle cramps, nausea and vomiting, flushing of face, headache, increased pruritus, chest pain, fever, and chills. The other is Machine-related complications: These complications are due to accidents or failure of safety mechanisms of hemodialysis treatment. They include air embolism, hemolysis, hyperthermia or hypothermia, blood loss, and conductivity problems (Ahmad, 2009). The complications of hemodialysis are due to the disease itself as well as the mode of renal replacement therapy (RRT). Kidney function can partially replace by dialysis, which provides only 5-10% of excretory renal function (Ahmad, 2009).When appropriate interventions are available early in the course of management, the potential for better health improves, and that patient can remain active in family and community life. Furthermore, mentioned that the health care team provides the information and support for patients and their families on how to preserve and protect their quality of life (Sirisan et al., 2013). According to my knowledge, there is scarcity in studies conducted in this issue in Ethiopia, and this study is an attempt to provide primary findings.1.2 Statement of the Problem Due to the Chronicity of End Stage Renal disease (ESRD), dialysis patients can spend years of treatment in centers with extensive interaction with dialysis staffs. The increasing number of patients with end stage renal disease (ESRD) worldwide and in Ethiopia has caused a substantial rise in the number of individuals receiving hemo-dialysis (Aliyie, 2014). Therefore, assessment of knowledge and practice of nurses on intradialetic complication is very essential.Success of hemodialysis is largely depends on monitoring the general condition and complications (e.g. hypotension, cramps & hypoglycemia). Nurses represent the first line of care and observation. Accordingly, the good knowledge expected to gain positive treatment outcome. Intradialytic complications are a constant threat for hemodialysis patients and dialysis staff (Sirisan et al., 2013). The nurse plays an important role in the control and protection of the patient. Events and complications due to dialysis can prevent and patients’ lives can increase with suitable care through the treatment period and appropriate nursing management with hemodialysis (Sirisan et al., 2013).1.3 Justification of the Study Chronic care like hemo-dialysis is subject to condition that causes the clients and health care provider feel exhaustion, due to its serious care and treatment. A simple and easy mistake can cause a serious complications and even death. Therefore, these conditions make both health care providers and clients live in trouble (Aliyie, 2014). Hemo-Dialysis is a lifelong care as far as kidney transplant is not doing, so patients on hemo-dialysis care are force to visit the dialysis center at least three times per week. Unless the care provided is not in appropriate way, its cause discourage to the service (Aliyie, 2014). The study conducted on knowledge and practice of nurses towards dialysis care is limited in Ethiopia. As far as, my knowledge concerned there is no study revealing knowledge and practice towards dialysis care in Ethiopia. Therefore, this study intended to assess knowledge and practice nurses regarding intradialysis complication among patients on maintenance hemo-dialysis.1.4 Significance of the Study There is increasing incidence and prevalence rates of patients treated by dialysis. The mortality rate among patients receiving chronic hemodialysis is high and greater than that of any other diseases. Therefore, there must be a clear identification of the skills and knowledge required by the nurse through educational intervention to carry out patient care effectively. Moreover, nurses constitute the largest number of personnel working in hemodialysis units. Any defect in their performance will affect the level of quality of care giving to the patient and patient life. For these reasons, this study will be conduct to assess knowledge and practice nurses regarding intradialysis complication among patients on maintenance hemo-dialysis.Therefore, the information obtained from this study will be useful for the health care workers who are working in the dialysis units. This research project study will also be baseline information for future researchers.Reference 1. Ahmad, S. (2009). Clinical Manual Dialysis.2. Aliyie, H. A. (2014). College of Health Sciences School of Allied Health Sciences Department of Nursing and Midwifery College of Health Sciences School of Allied Health Sciences. (June), 1–28.3. Gilbert, S. J., Weiner, D. E., Gipson, D. S., & Arbor, A. (n.d.). National Kidney Foundation’s Primer on Kidney Diseases sixth edition Gilbert Scott J., Weiner Daniel E. Bone Disorders in Chronic Kidney Disease. 2014; 276-287.4. Hinkle, J. 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