Date of Conferral

2023

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

AbstractThe prevalence rates for end stage renal disease (ESRD) have continued to rise by approximately 20,000 cases per year, and the number of patients with kidney failure requiring dialysis in the United States had reached 554,038 at the end of 2018. Transition of care for patients between acute care facilities and other care facilities such as dialysis centers remains challenging for providers. Lack of clear communication between providers, poor patient understanding of post-hospital self-care, and gaps in healthcare scheduling contribute to a high rate of adverse events. This facility did not have a detailed clinical guideline for ESRD communication between the inpatient and outpatient dialysis centers. The purpose of this study was to use an inter-professional team to develop a guideline specific to the transition of dialysis patients. The practice question was: Was an interprofessional team able to develop a new clinical practice guideline for the transition of ESRD patients? As the new guideline was developed, the expert committee reviewed the drafts using the consensus model approach with virtual conferencing. The final draft was reviewed by the committee using the AGREE II instrument to assess the validity and applicability of the proposed recommendations into clinical practice. There was 100% agreement on the quality of the guideline to recommend for practice use. However, the score on individual intent to use was lower, indicating more attention is needed to translating education to practice change. Inclusion in the electronic health record will help institutionalize this change. The project may improve communication among care providers, improve care for dialysis patients, and prevent adverse events.

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