Hospital Medicine, Cleveland Clinic Martin Health, Stuart, Florida, United States.
University of Virginia Transplant Center, University of Virginia Health, Charlottesville, United States.
Policy Polit Nurs Pract. 2021 Feb;22(1):51-62. doi: 10.1177/1527154420965932. Epub 2020 Oct 20.
The state of American kidney health is currently under the microscope. In the United States, approximately 20,000 persons advance to end-stage renal disease annually. Trends indicate accelerating increases in cost of care and a high mortality rate among patients with end-stage renal disease, with only 57% of patients surviving after 3 years. An executive order by the White House has placed the transformation of kidney care at the forefront of the country's health care agenda. The order focuses on key issues including improving outcomes, reducing treatment-related expenditures and increasing kidney donations. Mobilization of health care resources directed toward policymaking, workforce growth and development, and research will be critical to effectively achieve this executive order. Nursing's response, as the health care profession with the most members, will be crucial to achieving response implementation and success of the order. This article describes immediate and future actions including policy, leadership, clinical, educational, and research initiatives that the nursing profession should take to advance kidney health. It calls for specific actions by nursing and focuses on nursing organizations, nursing research, quality improvement initiatives, nursing innovation, advanced practice nursing, and the nephrology and transplant nursing workforce in order to improve kidney health nationally. The impact of the SARS-CoV-2 pandemic on kidney health and the implications for the profession of nursing are outlined. Although there are still many unknowns about the pandemic, nursing's voice is necessary to ensure the ongoing delivery of high-quality care.
美国的肾脏健康状况目前正受到密切关注。在美国，每年约有 20,000 人进展为终末期肾病。趋势表明，医疗护理成本加速增长，终末期肾病患者的死亡率很高，仅有 57%的患者在 3 年后存活。白宫发布的一项行政命令将肾脏护理的转型置于美国医疗保健议程的首要位置。该命令侧重于包括改善预后、降低治疗相关支出和增加肾脏捐赠在内的关键问题。动员医疗保健资源以制定政策、促进劳动力增长和发展以及开展研究对于有效实施该行政命令至关重要。作为拥有最多成员的医疗保健专业，护理的反应将对实现行政命令的实施和成功至关重要。本文描述了护理专业应采取的立即和未来行动，包括政策、领导力、临床、教育和研究举措，以促进全国的肾脏健康。它呼吁护理采取具体行动，并侧重于护理组织、护理研究、质量改进举措、护理创新、高级实践护理以及肾脏病和移植护理劳动力，以改善全国的肾脏健康。本文还概述了 SARS-CoV-2 大流行对肾脏健康的影响以及对护理专业的影响。尽管大流行仍有许多未知因素，但护理的声音对于确保高质量护理的持续提供是必要的。
