Date of Award

5-2020

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Theresa A. Kessler

Abstract

Chronic kidney disease (CKD) is associated with high healthcare costs, poor health outcomes and low quality of life (Donald et al., 2018). The US CKD prevalence is 15%, costing Medicare $79 billion in 2016 (United States Renal Data System, 2018). Self-management could reduce CKD burden (Jeddi, Nabovati, and Amirazodi, 2017). Mobile technology offers a low-cost, ease-of-access platform for chronic disease self-management (Whitehead & Seaton, 2016), potentially slowing disease progression and improving health outcomes (Jeddi, 2017). The purpose of this project was to utilize a CKD-specific mobile application, CARELogiQ, to facilitate symptom management; increasing patient satisfaction and decreasing hospitalizations and ER visits over three months. A five-database literature review yielded six high-quality articles; three level I, two level II, and one level III evidence based on JHNEBP (Dang & Dearholt, 2017). Evidence supports a multifaceted approach to effectively use a CKD-specific mobile application for patient and provider communications, appointment and biometric check reminders, education, and telemonitoring of BP and weight. The Stetler Model guided the project (Stetler, 2001). In a Northwest Indiana nephrology clinic, CARELogiQ was used to report symptoms, communicate with patients and providers, and record medical appointments. DaVita’s Kidney Smart© educational class provided education. Participants recorded weekly BP and weights manually in a log. Weekly calls collected BP and weight results, reminded participants to use CARELogiQ to report symptoms, encouraged medication adherence, and continued telemonitoring. Aggregate and person-to-person hospitalization/ER visit comparisons, and a post-intervention satisfaction-of-care survey were completed. Healthcare utilization was less in the intervention group (N = 10, M = 0.00, SD = 0.00) compared to the non-intervention group (N = 32, M = 0.125, SD = 0.42) (t(40) = .930, p = .36) . Rate of healthcare utilization in the intervention group (N = 10) did not change from pre (M = 0.00, SD = 0.00) to post-intervention (M = 0.00, SD = 0.00). Participants were satisfied with use of CARELogiQ. CARELogiQ has the potential to reduce healthcare utilization by improving self-management, thus effectively impacting CKD burden. Significant outcomes may be attainable for future CARELogiQ projects by increasing sample size, lengthening implementation time, increasing functionality of CARELogiQ, and providing a smart device to participants.

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J. Zamora DNP poster.pdf (31816 kB)
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