Nephrology Nursing Scope and Standards of Practice: Take Pride in Practice.

The Nephrology Nursing Scope and Standards of Practice, 9th Edition, published by the American Nephrology Nurses Association, defines the scope of nephrology nursing and provides standards of practice, standards of professional performance, and competencies for registered nurses and graduate-level prepared registered nurses (e.g., advanced practice registered nurses, clinical nurse specialists) in an approach consistent with the American Nurses Association's Nursing Scope and Standards of Practice, published in 2021. Discussions addressing respect, equity, inclusion, and social justice have been included in the 9th edition. A new section related to altered/crisis standards has been added to assist nephrology nurses in developing strategies for implementing those standards. The section on how to use the standards has been updated with forms that organizations can download and individualize. This article provides an overview of the scope, standards, competencies, and strategies for implementing them in clinical practice.

Nephrology Nursing Scope and Standards of Practice: Integration into Clinical Practice.

The eighth edition of the Nephrology Nursing Scope and Standards of Practice, published by the American Nephrology Nurses Association (Gomez, 2017), defines the scope of nephrology nursing practice, and provides standards of practice and professional performance in an approach similar to the American Nurses Association (ANA) 2016 standards. ANNA's eighth edition of the Nephrology Nursing Scope and Standards of Practice incorporates competencies for graduate level-prepared nurses in addition to the registered nurse (RN) and advanced practice registered nurse (APRN). The section on how to use the standards in practice has been updated with user-friendly forms. This article provides an overview of the scope of practice, standards, competencies, and situations that require intervention by the nephrology nurse.

Challenges facing nephrology nursing.

The health care system is in the midst of great change and nephrology nurses continually face challenges in their work environments. Nephrology nurses are well poised to meet these challenges by virtue of their numbers, scientific knowledge, and adaptive capacity, and providers would benefit from taking advantage of the contributions nurses can make.

Take action: a culture of safety.

Nephrology nurses can influence safety outcomes in all areas of nephrology care, including but not limited to dialysis access events, dialysis machine events, medication events, patient injury events, and staff injury events. Nephrology nurses are instrumental in recognizing and mitigating hazards. The Nephrology Nursing Scope and Standards of Practice (Gomez, 2011) states that the nephrology registered nurse practices in an environmentally safe and healthy manner. One of the competencies for the nephrology nurse is: Promotes and monitors the practice environment for appropriate infection control practices including consumer safety, environmental, and equipment concerns, which impact the healthcare consumer. Do you feel safe? Do your patients feel safe? Take action - ensure that your organization has a culture of safety; volunteer to be a member of the safety committee; review policies and procedures; identify potential hazards.

Take action: competence.

As our nursing specialty evolves, competency in the rapidly changing healthcare environment remains a key component in our ability to produce positive patient outcomes. Competency gives us confidence to care for our patients. But developing competency is just one step to becoming an expert nurse. Nurses' expertise and competency grows over the years--a product of experiences.

Five challenges impacting nephrology nursing.

Nephrology nurses are continually facing unique challenges in their work environments. The development of skills to help navigate these challenges while continuing to provide quality care in our specialty critical.

A model for initiating change in the dialysis setting using an implementation plan.

Change has become a constant in the workplace. Although the staff may resist change and feel it is happening too quickly, leading change is a critical component for nurse leaders. It is important for the registered nurse to take the lead and guide the staff through the process.

Take action: influence diversity.

Increased diversity brings strength to nursing and ANNA. Being a more diverse association will require all of us working together. There is an old proverb that says: "one hand cannot cover the sky; it takes many hands." ANNA needs every one of its members to be a part of the diversity initiative.

A model for initiating change in the dialysis setting.

Implementing a significant change in an organization is one of the most challenging endeavors that faces a manager. If the change involves the establishment of new paradigms that will replace the existing ways of doing business, the challenge is particularly daunting. Change theory is a process that can be used to facilitate change in an organization. It provides a guide for the manager to follow in attaining a desired outcome. Several change theorists and their works are discussed. An example is provided using change theory to identify strategies for delivering a medication once per month from once a treatment.

Incorporating the nephrology nursing scope and standards of practice into clinical practice.

The recently released American Nephrology Nurses' Association (ANNA) Nephrology Nursing Scope and Standards of Practice, 7th edition, provides a broad foundation for defining and evaluating nephrology nursing practice. ANNA's standards present a similar approach as the American Nurses Association (ANA) 2010 standards. The ANNA Nephrology Nursing Scope and Standards of Practice, 7th edition, is expanded to incorporate a section on how to use the standards in practice. This article provides an overview of the scope of practice, standards, and situations that require intervention by nephrology nurses. Samples of tools that can be used to incorporate the standards into the various situations are discussed.