Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Mary C. Garner

Abstract

AbstractChronic kidney disease (CKD) prevalence rates have been on the rise in recent years, and currently, about 37 million Americans are living with the disease. Most patients with CKD progress to end-stage renal disease (ESRD), resulting in additional treatments, including kidney transplants and hemodialysis (HD). HD treatments depend on patients’ adherence to self-management practices. The practice gap was the lack of guidelines for staff to use with ESRD patients to teach self-management strategies. This project aimed to develop an evidence-based clinical practice guideline (CPG) on a self-management support program for dialysis patients for use by health care providers at the dialysis unit. An evidence-based CPG provides an educational guide to plan comprehensive care and recommends optimizing patient care. In addition, the CPG emphasizes individualized interventions to enhance self-management. To achieve this, a search for relevant literature with credible research evidence led to the development of the guideline for self-management for dialysis patients. The invited interprofessional team of evaluators are familiar with CPGs and are experts in ESRD. The evaluators used the Appraisal of Guidelines Research and Evaluation (AGREE) II to assess the quality of the CPG. The percentage of agreement for the six domains of the AGREE II ranged from 88.9% to 98.1%, which is well above the 70% threshold for a high-quality practice guideline. All six reviewers rated the CPG ready for use. Applying a self-management support program would positively impact patients with ESRD on HD. When patients have self-management knowledge, it can improve health outcomes, minimizes the risk of complications, and reduces frequent hospital readmission.

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