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Chronic kidney disease (CKD): Attitudes and barriers to increasing early referral to CKD education
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Borelli, Marisa. Chronic kidney disease (CKD): Attitudes and barriers to increasing early referral to CKD education. Retrieved from https://doi.org/doi:10.7282/t3-2jqf-yg35

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TitleChronic kidney disease (CKD): Attitudes and barriers to increasing early referral to CKD education
NameBorelli, Marisa (author); Cadmus, Edna (chair); Rutgers University; School of Nursing - RBHS
Date Created2019
Other Date2019-05 (degree)
SubjectChronic kidney disease, Post-Master's DNP Leadership, Chronic renal failure, Nephrologists
Extent1 online resource (100 pages) : illustrations
DescriptionPurpose: The purpose of this project were to evaluate the barriers in nephrologists using a Chronic Kidney Disease (CKD) program and implement strategies to improve referral rates, ultimately improving patient outcomes.
Methodology: This were a quality improvement project including a retrospective chart review, survey to the nephrologists, and intervention. The interventional component consisted of education presented to the nephrologists about the benefits of a CKD program, the outcomes of a CKD program, what's covered in a CKD program, an algorithm for referral, and standardized referral forms. The sample were 43 credentialed nephrologists within the dialysis units of a CKD program in central New Jersey and incident dialysis patients meeting the inclusion criteria.
Results: There were no difference in the referral rate to the CKD program pre- or post- intervention. Patients starting on dialysis who transitioned from a CKD program were more likely to chose peritoneal dialysis, start therapy as an outpatient, and start with a fistula or graft. The outcomes of the CKD program are consistent with that of the literature. The physician survey identified barriers to referral including late referral to nephrologist (76.9%), perceptions of patients motivation to attending the program (61.5%), and knowledge of the program (46.2%). All of the six nephrologists that received the education on the CKD program felt the education was useful and were more likely to refer patients going forward.
Implications for Practice: To increase patient compliance with attending a CKD program, nephrologists should promote and encourage participation of the CKD program. There is a need to educate primary care physicians on when to refer patients to nephrologists as many patients are referred to nephrologists with late stage CKD. Additionally, promoting the program to patients in acute care settings with renal impairment may be beneficial in slowing down kidney function decline. Since this was a small sample size and a single site setting, the findings of the physician survey cannot be generalized to a greater population.
NoteDNP
NoteIncludes bibliographical references
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/t3-2jqf-yg35
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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