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Implementing Evidence-Based Vitamin D Protocol in the Dialysis Clinic: An Educational Approach.

Chigozie Uko1,2,3, Rose Utley4,5

  • 1Nurse Practitioner, Georgia Nephrology, Lawrenceville GA.

Nephrology Nursing Journal : Journal of the American Nephrology Nurses' Association
|July 9, 2020
PubMed
Summary

Vitamin D deficiency is common in dialysis patients. Educating staff improved screening from 29% to 100%, revealing 70% deficiency, but follow-up monitoring needs improvement.

Keywords:
chronic kidney disease (CKD)hemodialysiskidney failurevitamin D deficiencyvitamin D insufficiency

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Area of Science:

  • Nephrology
  • Endocrinology
  • Quality Improvement Science

Background:

  • Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD).
  • Deficiency is more pronounced in patients with kidney failure undergoing dialysis (peritoneal and hemodialysis).

Purpose of the Study:

  • To assess if educating providers and clinical staff on vitamin D guidelines improves awareness and monitoring of vitamin D levels in hemodialysis patients.
  • To evaluate the impact of a quality improvement initiative on vitamin D screening and follow-up protocols.

Main Methods:

  • A nurse practitioner-led quality improvement project was implemented in an outpatient hemodialysis unit.
  • Education on vitamin D guidelines was provided to healthcare providers and clinical staff.
  • Patient screening rates for vitamin D levels were tracked before and after the intervention.

Main Results:

  • The percentage of patients screened for vitamin D levels increased from 29% to 100%.
  • Of the patients tested, 70% were found to be deficient in vitamin D.
  • Follow-up monitoring for vitamin D levels was achieved in only 32% of patients.

Conclusions:

  • Provider and staff education significantly increased vitamin D screening rates in hemodialysis patients.
  • Despite improved screening, consistent follow-up monitoring remains a challenge.
  • Recommendations for sustainability include ongoing education, system prompts, continuous monitoring, and dedicated champions.