Date of Award
Spring 4-30-2023
Document Type
Thesis
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Advisor
Dr. Kirk Hummer, DNP, MBA, RN, APRN, CNP
First Committee Member
Dr. Kirk Hummer, DNP, MBA, RN, APRN, CNP
Second Committee Member
Dr. Chai Sribanditmongkol PhD, RN, IBCLC, CNS
Third Committee Member
Joy Shoemaker DNP, APRN, FNP-BC, CNE
Keywords
Nephrology, End Stage Renal Disease, Chronic Kidney Disease, Referrals
Subject Categories
Medicine and Health Sciences
Abstract
End-stage renal disease may greatly affect a patient’s overall health and outcomes. This project aimed to look at early versus late nephrology referrals. A retrospective chart review of patient’s demographic and health outcome data was reviewed through a patient’s electronic health record. The patient data from the chart review, along with the evidence obtained from the review of the literature has been utilized to describe findings and develop evidence-based practice-guided recommendations for nephrology referrals in clinical practice. This project has been completed at a dialysis center in rural Ohio. The patient population included around 60 patients who had dialysis at the clinic within the past year. Excluding patients with a genetic or an acute kidney disease. This project has taken place from August 2022 to March 2023. The model of the project was a retrospective quantitative chart review. The patient’s charts were reviewed looking for demographic information, stage of chronic kidney disease at initial contact with a nephrologist and lab values. Information was then collected on time to start dialysis, fistula placement, lab values including, potassium, phosphorous, hemoglobin, blood urea nitrogen, mortality, and hypertensive control. The information was organized in a data collection sheet. The information was then organized into an excel spreadsheet which was password protected to keep information private. Barriers to this project included missing medical history from electronic health records (EHR), patient compliance with treatment plans and available patient population. The data collected showed a clear correlation between earlier nephrology referrals and improved patient outcomes. Improved outcomes included blood pressure control, decrease in potassium levels, decrease in time prior to having to start HD. Given the evidence presented patients should be referred to a nephrologist when a patient is approaching a stage 3a. Providers should be referring patients earlier prior to a significant decrease in kidney function. This project will improve clinical practice, health, and the life expectancy of patients with ESRD.
Acknowledgement 1
1
Acknowledgement 2
1
Licensing Permission
Copyright, all rights reserved. Fair Use
Recommended Citation
Brown, Tricia, "Early vs Late Referrals to Nephrology and its Effect on Patient Outcomes in End-Stage Renal Disease (ESRD) Patients Who Are on Renal Replacement Therapy (RRT) a Retrospective Chart Review" (2023). Doctor of Nursing Practice Scholarly Projects. 101.
https://digitalcommons.otterbein.edu/stu_doc/101
Poster