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Dissertation
Improving outcomes of chronic kidney disease: a quality improvement project to diagnose and manage high-risk patients
Doctor of Nursing Practice (D.N.P.), Drexel University
29 Jun 2021
DOI:
https://doi.org/10.17918/00001525
Abstract
Background: Chronic kidney disease (CKD) is a common illness associated with significant rates of morbidity and mortality. Early diagnosis and appropriate management may prevent or slow the progression of CKD to end-stage renal disease (ESRD) where dialysis or kidney transplant is necessary for survival. Primary care providers (PCPs) are responsible for screening, diagnosing, and monitoring CKD progression. However, many PCPs lack awareness of diagnostic and clinical management protocols. Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines for screening, diagnosing, and managing CKD do exist, but the application of these guidelines in clinical practice is inconsistent. Objective: The purpose of this quality improvement (QI) project was to evaluate whether a KDOQI guideline-based PCP education program and checklist tool influenced the incidence of CKD screening, accurate diagnosis, and appropriate clinical management at a small primary care clinic in rural Pennsylvania. Method: The PCP education program and checklist tool were introduced to the clinic through the Plan-Do-Study-Act (PDSA) methodology. Pre-implementation and post-implementation data were collected via retrospective chart review. Data was then analyzed to compare PCP adherence to KDOQI guidelines pre- and post- intervention implementation. Results: The PCP education program and checklist tool significantly improved PCP adherence to some of the KDOQI guidelines. The intervention increased CKD screening by 24% (p = .001) and nephrotoxic drug counseling by 17% (p = .023). The intervention did not have a significant effect on CKD diagnosis or mineral bone disease (MBD) monitoring.
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Details
- Title
- Improving outcomes of chronic kidney disease
- Creators
- Megan E. Gleason
- Contributors
- Patti Rager Zuzelo (DNP Chair)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 54 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Doctoral Nursing; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 991020220848704721