School of Nursing

Yonhee Seo

Pathway to postgraduate studies

Yonhee was qualified as a registered nurse in Korea in 2001 and worked in surgical intensive care unit for 3 years. She wanted to have an overseas experience as a nurse. So she came to New Zealand and consolidated a clinical career with a focus on intensive care nursing (cardiothoracic vascular intensive care unit) for five years in New Zealand. While working in cardiothoracic vascular intensive care unit, she was often exposure to acute kidney failure patients requiring continuous veno-venous hemofiltration and slow extended daily dialysis after cardiac surgery. She then developed her interesting to chronic kidney failure patients. She has worked in haemodialysis unit for last two years where she has facilitated patient’s education regarding chest pain assessment and management as well as the impact of blood pressure medication in haemodialysis unit at Auckland City Hospital. Since she has worked in haemodialysis unit, she has been fascinated by the delicate condition of renal patients which made her interested to select her Master’s thesis involving haemodialysis patients. Based on her clinical career in both cardiothoracic vascular intensive care and haemodialysis units, she wanted to consolidate her nursing knowledge. She started her postgraduate studies and graduated with a Diploma in Health Sciences (advanced nursing) at the University of Auckland in 2009 and she is currently doing her Master of Nursing at the University of Auckland

Current work

'The effect of online-haemodiafiltration on peri-dialysis blood pressure compared to standard haemodialysis, in a dependent care haemodialysis population.'

Yonhee conducted a clinical audit looking at the effect of online-haemodiafiltration on stabilising blood pressure during peri, intra and post haemodialysis treatment compared to standard haemodialysis, in patients with end stage kidney disease. The reason why she chosen this research topic is that the prevalence of dialysis dependent patients in New Zealand increased from 1715 patients in 2003 to 2064 patients (488 pmp) in 2007. Of these patients, 78% were treated with haemodialysis. The mortality rate of dialysis patients is high. Cardiac episodes were the most common cause of death in 2007, accounting for 41% in New Zealand. Blood pressure control is thought to be one of the most important contributing factors in influencing survival. Although controlled blood pressure plays a pivotal role in reducing cardiovascular disease and mortality of patients on haemodialysis, the interventions to stabiles blood pressure for patients receiving haemodialysis is a still ongoing issue in both internationally and New Zealand. Recent studies have introduced online-haemodiafiltration as an alternative to standard Haemodialysis. Online-haemodiafiltration is a relatively new dialysis technique and is more efficient in stabilising blood pressure for haemodialysis patients compared to standard haemodialysis. As a result, Auckland Health District Board has introduced online-haemodiafiltration to all patients requiring haemodialysis treatment since 2008. For this clinical audit, Yonhee developed a clinical audit tool based on existing database in the haemodialysis unit. Yonhee reviewed total 52 patients’ clinical records including medication charts, haemodialysis prescription and blood test results, those who met inclusion criteria. She found that there were significant differences between pre and post-diastolic blood pressure only in standard haemodialysis with p value of 0.03. However, there was no effect of online-haemodiafiltration on pre and post-diastolic blood pressure. In terms of the differences in mean pre and post blood pressure between standard haemodialysis and online-haemodiafiltration, there was no difference between mean pre and post-dialysis systolic blood pressure with standard haemodialysis and online-haemodiafiltration, however there was a significant difference of both mean pre (p=0.000) and post-dialysis diastolic blood pressure (p=0.006) between standard haemodialysis and online-haemodiafiltration. There was no correlation between the proportion of patients taking antihypertensive drugs and the proportion of patients achieving the target pre and post blood pressure between standard haemodialysis and online-haemodiafiltration. There was also no difference in achieving target weight between standard haemodialysis and online-haemodiafiltration. Unlikely other studies conducted overseas, she found there were two more patients from online-haemodiafiltration group experienced intradialytic hypotension.

Throughout her master studies Yonhee developed her passion for caring for patients with chronic conditions such as dialysis patients. She is currently aiming at consolidating her career to renal nursing such as haemodialysis and peritoneal dialysis and hope she will become a nurse specialist in dialysis nursing in the future.