Associate Professor, Rutgers University School of Nursing, Newark, NJ.
member of ANNA's Jersey South Chapter.
Nephrol Nurs J. 2022 Mar-Apr;49(2):109-120.
The End-Stage Renal Disease Treatment (ETC) Model, an aspect of the Advancing American Kidney Health Initiative implemented by the Centers for Medicare and Medicaid Services (CMS) in 2019, is designed to shift the predominant in-center hemodialysis dialysis model in the United States to a home dialysis model. This shift represents a monumental change in the treatment of end stage kidney failure and is occurring amid a strained nursing workforce. The CMS Conditions for Coverage for dialysis facilities mandate registered nurse responsibility for the conduct of patients' home dialysis training, and the current nursing shortage presents challenges because the need for nephrology nurses will increase to meet the growing demand for home dialysis during the ETC implementation period. As the ETC Model is implemented in randomly selected dialysis facilities across the United States, nephrology nurses must have leading roles as full partners with CMS and other stakeholders for the mutual determination of short- and long-term solutions for meeting the growing home dialysis training demands.
终末期肾脏疾病治疗（ETC）模式是 2019 年医疗保险和医疗补助服务中心（CMS）实施的推进美国肾脏健康倡议的一个方面，旨在将美国主要的中心血液透析模式转变为家庭透析模式。这种转变代表了终末期肾衰竭治疗的重大变化，而且是在护理人员紧张的情况下发生的。CMS 的透析设施覆盖条件要求注册护士负责患者家庭透析培训，而目前的护理人员短缺带来了挑战，因为在 ETC 实施期间，需要增加肾病护士来满足对家庭透析日益增长的需求。随着 ETC 模型在美国各地的随机选择的透析设施中实施，肾病护士必须作为 CMS 和其他利益相关者的全面合作伙伴，发挥主导作用，共同确定短期和长期解决方案，以满足不断增长的家庭透析培训需求。
