Nurses’ roles in the care of patients with CKD and factors affecting these roles: a mixed methods systematic literature review

Chronic kidney disease (CKD) is a progressive disorder that affects more than 10% of the global population, or more than 840 million people (Jager et al., 2019). Caring for patients with CKD presents a financial and medical burden because of the high morbidity and mortality risk associated with the disease (Hsu et al., 2006). The worldwide mortality rate from CKD increased by 41.5% from 1990 to 2017 (Bikbov et al., 2020). The large number of people afflicted, and the severe negative effect of CKD should inspire further efforts for better prevention, treatment, and care. This systematic literature review aims to capture all the available literature on nurses’ roles related to CKD patients care and the factors affecting these roles as well as to identify any gaps in the literature. Search was conducted in two phases, in 2014 and 2019, and explored four electronic databases (CINAHL, British Nursing Index, PubMed, and Science Direct). Eventually, 19 articles met the inclusion criteria and were included in the present literature review. The study revealed a number of roles including the provision of care, patient education and supporting self-care and self-management, but highlighted that the operation of the haemodialysis machine and the safety of the patient during the dialysis session was a major one. Patient education is only provided by expert nurses who represent the minority of the nursing workforce in field of nephrology care. Additionally, numerous factors affecting these roles were identified such as nurses’ knowledge, shortage of nurses and time restrictions, support by nursing administration, and availability of resources and further opportunities for professional development.