A bstract
One way to drive change in clinical practice in the renal service is through initiatives funded by central government, either
pilot projects, or new clinical tools, protocols and resources, or new national programmes. Such initiatives reflect changing
priorities on the national health policy agenda that are determined by the interplay of a range of stakeholders in the health
arena.
Nurses with renal backgrounds working within central government can influence the processes and debates that give rise
to these policy initiatives. They can ensure key decision makers who set national health priorities are well informed about
renal services and their priorities. They can facilitate effective engagement between the various stakeholder groups to reach
agreement on priority initiatives for renal services.
In New Zealand several areas in nephrology have recently reached the national health policy agenda.These initiatives, in
chronic kidney disease management, renal transplantation and new renal consumer information resources, exemplify the
potential for renal nursing to change clinical practice by influencing policy.