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Chronic kidney disease (CKD): Attitudes and barriers to increasing early referral to CKD education
Descriptive
TitleInfo
Title
Chronic kidney disease (CKD): Attitudes and barriers to increasing early referral to CKD education
Name
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Borelli
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Marisa
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1988-
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Marisa Borelli
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author
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Advisory Committee
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chair
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Rutgers University
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degree grantor
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School of Nursing - RBHS
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school
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theses
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2019
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2019-05
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English
Abstract
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Purpose: 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.
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.
Subject
(authority = local)
Topic
Chronic kidney disease
Subject
(authority = RUETD)
Topic
Post-Master's DNP Leadership
Subject
(authority = LCSH)
Topic
Chronic renal failure
Subject
(authority = LCSH)
Topic
Nephrologists
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Rutgers University Electronic Theses and Dissertations
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ETD_9928
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1 online resource (100 pages) : illustrations
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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doi:10.7282/t3-2jqf-yg35
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(authority = ExL-Esploro)
ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
FamilyName
Borelli
GivenName
Marisa
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Copyright Holder
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Permission or license
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2019-04-29 13:41:16
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Name
Marisa Borelli
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Affiliation
Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Embargo
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2019-05-31
DateTime
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2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2019-03-29T20:45:45
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2019-03-29T20:45:45
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