Nurse-Led Quality Improvement in Children with Kidney Disease

Thursday, 25 July 2013: 3:15 PM

Betsie G. I. van Gaal, PhD, RN1
Jacqueline L. Knoll, MANP2
Marlies E. A. M. Cornelissen, MD PhD2
Theo van Achterberg, RN, PhD1
(1)Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
(2)Pediatric Nephrology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

Learning Objective 1: The learner will be able to understand the Nurse-Led quality intervention for children with a chronic kidney disease

Learning Objective 2: The learner will be aware of the improvements in the treatment for children with a chronic kidney disease achieved by the Nurse-led intervention

Purpose: To improve the quality of care for children with a chronic kidney disease, a registered nurse experienced in the care for children with a chronic kidney disease was appointed as an additional member of the Paediatric Nephrology team at the outpatient clinic. The aim of the study was to evaluate whether the quality of care given by the team improved.

Methods: For this evaluation, we designed a non-controlled before and after study in four outpatient clinics in the Netherlands.

Together with parents of children with a chronic kidney disease and the professionals of the participating paediatric nephrology team, we developed indicators to measure the quality of care.

After informed consent, 149 parents participated in this study. The files of their children were screened and the parents and the professionals were interviewed.

Results: The nurses at the four outpatient clinics gave parents and the children information about the treatment, medication and side effects, nutrition in relation to the chronic kidney disease and the influence of exercise. Additional they also took care of more practical tasks. According to the parents, the accessibility of the team improved and they were satisfied with the nurses, the medical doctor and the other paediatric nephrology team members. The paediatric nephrologists found the role of the nurse important and experienced having more time for the medical treatment of the children.

Conclusion: The quality of care improved at outpatient clinics improved as a result of adding experienced nurses to the team, especially with regard to  the information to parents and children. For the nurses it remains challenging to further improve the coordination of the care for these children.