Increasing Adherence in ESRD Patients
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Kidney disease is the eighth leading cause of death in the United States; around 10% of the population has chronic kidney disease (American Kidney Fund, 2012). One factor identified as impacting mortality rates in the End Stage Renal Disease (ESRD) population is nonadherence to dialysis treatments. Interventions focused on empowering patients and determining the root cause of nonadherent behavior are effective forms of interventions to decrease the risk of mortality in this population. Nurse Practitioners (NPs) are utilized in the outpatient facilities to support nephrologists in care for these patients and play a vital role in increasing adherence in this population. This was a quality improvement project that was nonexperimental and observational in nature. Individualized data was collected through the administration of the End Stage Renal Disease Adherence Questionnaire (ESRD-AQ) survey, identifying barriers specific to that patient, then implementing interventions specific to the identified barrier. Overall missed treatment rate for all participants was an average of 32.4%. Following administration of the ESRD-AQ survey and implementation of intervention specific to identified barriers was 43.4% average missed treatment rate. Implementation of the ESRD-AQ survey to identify individualized barriers within the outpatient dialysis helped to focus interventions specific to that patient. Due to the nature and impact of high missed treatment rates increasing hospitalization rate, several of the participants were hospitalized for extended periods of time during the project period.