The Impact of a Pre-End Stage Renal Disease Education Intervention on Central Venous Catheter Placement in Those Initiating Dialysis: A Quality Improvement Project Public Deposited

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  • March 19, 2019
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  • Boykin, Heather
    • Affiliation: School of Nursing
Abstract
  • Chronic kidney disease (CKD) continues to be a growing public health problem. Education focused on time-sensitive objectives, specifically vascular access preparation for dialysis, must be addressed to avoid unnecessary complications and poor outcomes. Therefore, the purpose of this project was to study the potential impact of a patient education intervention to decrease the placement of central venous catheters in patients initiating dialysis. The project focused specifically on informing and encouraging patients, through education, to plan for and obtain optimal methods of vascular access in advance of the need for hemodialysis. Ten adult patients with CKD in stage four or five were recruited through an outpatient nephrology office. Individuals participated in a face-to-face, one hour, pre-established education session provided by an expert nurse practitioner, and structured based upon the Centers for Medicare and Medicaid standards. Interview-style questionnaires were administered pre-session, immediately after, and four weeks following the education. Outcomes related to the effectiveness of the session and vascular placement were obtained. All participants found the session either `helpful' or `the reason' for decision making regarding dialysis modality choice and access planning. Half commented that the session specifically addressed their knowledge of kidney disease, its progression and treatment options, and risks associated with central venous catheter use. Of the 10 patients, 2 indicated that they had non-catheter access placed prior to the education class; 4 patients were referred for vascular access placement; and 2 patients elected peritoneal dialysis and therefore did not need vascular access placement. A timely, pre-ESRD education session focused on dialysis modality selection and vascular access planning has the potential to reduce central venous catheter placement in those initiating dialysis. Future exploration is needed, on a larger scale, to identify the impact of an education session on patient outcomes.
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  • In Copyright
Advisor
  • Zomorodi, Meg
  • McQueen, Laura
  • Gilet, Connie
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2014
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  • Chapel Hill, NC
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