Martin R K
University of California, San Diego Medical Center, 92103, USA.
EDTNA ERCA J. 2002;Suppl 2:43-5, 53. doi: 10.1111/j.1755-6686.2002.tb00256.x.
Since its inception, continuous renal replacement therapy (CRRT) has been performed in critical care units with or without the involvement of nephrology nursing support (1,2). It is apparent that the issue of providing care to patients requiring this therapy is not so much a debate on the nursing control of CRRT, but a focused discussion on the nursing management and delivery of care to the patient receiving CRRT in the intensive care setting. Although the choice of a nursing care model for CRRT is dependent on many clinical and organisational factors, the use of one nursing specialty to deliver CRRT care can leave gaps in practice. The Joint or Collaborative Nephrology/critical care nursing model brings the highest level of nursing expertise to the bedside. The joint model tends to promote collaboration between two distinct nursing specialties, with opportunities for setting joint standards and promoting research. With this in mind, this discussion will examine some of the factors affecting structuring of nursing care, describe nursing models currently in use, compare the attributes of each, and conclude which model is preferred for the delivery of nursing care for CRRT.
自连续肾脏替代疗法（CRRT）问世以来，无论有无肾脏病护理支持的参与，其都在重症监护病房中开展（1,2）。显然，为接受该疗法的患者提供护理这一问题，并非主要围绕CRRT的护理控制展开争论，而是聚焦于在重症监护环境下对接受CRRT治疗的患者进行护理管理和护理服务的讨论。尽管CRRT护理模式的选择取决于许多临床和组织因素，但由单一护理专业提供CRRT护理在实践中可能会存在不足。联合或协作肾脏病/重症护理模式能将最高水平的护理专业知识带到床边。联合模式倾向于促进两个不同护理专业之间的协作，有机会制定联合标准并推动研究。鉴于此，本讨论将审视影响护理结构的一些因素，描述当前使用的护理模式，比较每种模式的特点，并得出哪种模式最适合用于CRRT护理服务的结论。
