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Nursing attendance to hemodialysis patients: organic patterns application to underline nurses' expertises and improve job qualities

The change in clinical practice organization in a busy Hemodialysis Unit can be a key factor to implement clinical practice skills and define the professional growth of nursing staff. The change implied moving from a technical paradigm of care, towards an holistic approach of care, based on nurses' reliability and customized patient's care. The process applied the basic principles of Primary Nursing and Case Management, allowing and encouraging nurses to achieve a professional behavior based on deeper clinical knowledge, self-education and greater professional satisfaction while delivering a more efficient and better perceived nursing care. Organizational changes allowed nursing groups to define clearer and structured clinical competence pathways. The possibility to insert the change in clinical practice models within a Hospital broad frame of objectives, allowed economic sustainability and efficient management of human and technology resources in the starting phase. The model definition and its structured implementation is an ongoing Unit process and a challenge to quality, for all healthcare professionals involved.