Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers.
Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers.
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DOI：
10.1186/1471-2369-14-230
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发表时间：
2013-10-24
期刊：
影响因子：
2.3
通讯作者：
National Kidney Foundation
中科院分区：
文献类型：
--
作者：
Estrella MM;Jaar BG;Cavanaugh KL;Fox CH;Perazella MA;Soman SS;Howell E;Rocco MV;Choi MJ;National Kidney Foundation
国家肾脏基金会（NKF）肾病结局质量倡议（KDOQI）制定了慢性肾病（CKD）患者护理指南。虽然这些指南通过NKF的网站和出版物传播，但指南的使用仍然不理想。KDOQI教育委员会的成立是为了确定指南实施的障碍，确定提供者和患者的教育需求，并开发工具来改善CKD患者的护理。2010年5月至9月进行了一项在线调查，以评估肾脏提供者对指南的熟悉程度、当前使用情况以及对指南和实施指南工具的态度。大多数应答者报告经常使用指南，并认为它们可以很容易地实施到临床实践中；然而，大约一半的人发现了至少一个障碍。医生和医师扩展人员最常见的理由是缺乏支持KDOQI指南的证据，而联合卫生专业人员最常见的原因是患者不遵守指南，指南目标不切实际以及提供者时间限制。提供者认为指南包含了太多的细节，并且认为缺乏快速的资源是临床实施的障碍。大多数人都不知道临床行动计划。感知障碍在肾脏临床医生和专职卫生专业人员之间存在差异；需要为不同的提供者量身定制教育和实施工具。
The National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (KDOQI) developed guidelines to care for patients with chronic kidney disease (CKD). While these are disseminated through the NKF’s website and publications, the guidelines’ usage remains suboptimal. The KDOQI Educational Committee was formed to identify barriers to guideline implementation, determine provider and patient educational needs and develop tools to improve care of patients with CKD. An online survey was conducted from May to September 2010 to evaluate renal providers’ familiarity, current use of and attitudes toward the guidelines and tools to implement the guidelines. Most responders reported using the guidelines often and felt that they could be easily implemented into clinical practice; however, approximately one-half identified at least one barrier. Physicians and physician extenders most commonly cited the lack of evidence supporting KDOQI guidelines while allied health professionals most commonly listed patient non-adherence, unrealistic guideline goals and provider time-constraints. Providers thought that the guidelines included too much detail and identified the lack of a quick resource as a barrier to clinical implementation. Most were unaware of the Clinical Action Plans. Perceived barriers differed between renal clinicians and allied health professionals; educational and implementation tools tailored for different providers are needed.