Date of Conferral
8-19-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Joan Hahn
Abstract
This Doctor of Nursing Practice project focused on developing and validating a clinical practice guideline (CPG) to improve the early identification of chronic kidney disease (CKD) among at-risk adults in a primary care practice. The project addressed a site-specific practice gap involving the inconsistent use of evidence-based CKD screening, particularly estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) testing, which may delay diagnosis and treatment (Kidney Disease: Improving Global Outcomes [KDIGO] CKD Work Group, 2024). The purpose of this project was to develop an evidence-based CPG and evaluate its quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The practice-focused question asked whether the guideline would achieve at least 70% agreement across the six AGREE II domains. Guideline development followed the Johns Hopkins Evidence-Based Practice (JHEBP) Model and was informed by a systematic review, critical appraisal, and synthesis of current evidence. Four content experts, including two internal medicine providers and two nephrologists, independently evaluated the guideline using the AGREE II instrument. Five of the six AGREE II domains exceeded the predetermined benchmark of 70%, and the guideline received an overall quality rating of 6.25 out of 7. Three reviewers recommended the guideline for use, and one recommended its use with modifications, which were incorporated into the final CPG. The primary product of this project was a validated CPG that provides standardized recommendations for risk-based CKD identification in primary care. Although implementation was beyond the scope of the project, the guideline has the potential to improve early CKD detection, promote equitable access to evidence-based screening, and support evidence-based nursing practice.
Recommended Citation
Ugo, Catherine, "Guideline for Early Identification of Chronic Kidney Disease in At-Risk Adults in Primary Care" (2026). Walden Dissertations and Doctoral Studies. 20661.
https://scholarworks.waldenu.edu/dissertations/20661
