Putting the 'C' back into continuous renal replacement therapy.

It may seem obvious that continuous renal replacement therapy (CRRT) means that the treatment is truly continuous--administered without interruption on a 24/7 basis. In reality, a number of barriers limit the continuous aspect of CRRT. This article describes how nursing staff of an inpatient dialysis unit in a large Midwestern academic institution identified these barriers and developed and implemented a multifaceted plan to optimize CRRT.

A preceptor café: serving up universal values for preceptors.

How do you affirm meaning and articulate values that will serve as the bedrock of a preceptor program? The Medical Specialty Preceptor Committee in a large hospital system planned a series of preceptor forums for 88 medical specialty preceptors. The goals were to renew commitment, refresh vision, and develop strategies for successfully orienting new hires. This study began by examining the work of JoEllen Koerner in her book Healing Presence: The Essence of Nursing. The universal values in her model involve acknowledging and addressing three basic levels: safety needs, relationship needs, and self-esteem needs, encompassing the individual's connection to the external world. The middle level is labeled transformation and goes beyond the first three levels to how the individual expresses the authentic self within the working world. The higher levels involve intuition, intention, and self-actualization and focus on the inner world of the individual. The needs of orientees could be met in all of these dimensions, based on existing structure and process in the organization. Relationship-based care as our nursing model guides holistic care. Our rich institutional heritage promotes values-based teamwork. Our goal was to articulate these values and hold discussions among preceptors about how these values could be expressed and developed in orientees. These café conversations were held as spring forum sessions. This article highlights essential ideas at the core of this preceptor activity.