Patient satisfaction with nurse‐led chronic kidney disease clinics: A multicentre evaluation

Abstract

SUMMARY Background There is growing international evidence that nurse‐led chronic kidney disease (CKD) clinics provide a comprehensive approach to achieving clinical targets effective in slowing the progression of CKD. Across Queensland, Australia, these clinics have been established in many renal outpatient departments although patient satisfaction with these clinics is unknown. Objectives To measure patient satisfaction levels with CKD nurse‐led clinics. Method This was a cross‐sectional study undertaken at five clinics located in metropolitan, regional and remote hospitals in Queensland. Participants were >18 years of age (no upper age limit) with CKD (non‐dialysis) who attended CKD nurse‐led clinics over a six month period (N = 873). They completed the Nurse Practitioner Patient Satisfaction questionnaire which was modified for CKD. Results The response rate was 64.3 % (n = 561); half of the respondents were male (55.5 %), there was a median age range of 71–80 years (43.5 %) and most respondents were pensioners or retired (84.2 %). While the majority reported that they were highly satisfied with the quality of care provided by the nurse (83.8 %), we detected differences in some aspects of satisfaction between genders, age groups and familiarity with the nurse. Overall, patients’ comments were highly positive with a few improvements to the service being suggested; these related to car‐parking, providing more practical support, and having accessible locations. Conclusion In an era of person‐centred care, it is important to measure patient satisfaction using appropriate and standardised questionnaires. Our results highlight that, to improve services, communication strategies should be optimised in nurse‐led clinics.

A rapid review exploring nurse‐led memory clinics

“…Similar results have been reported with other nurse‐led clinics (i.e. clinics being led by Registered Nurses, specialist nurses and/or nurse practitioners, with varying degrees of autonomy and responsibility) in areas such as orthopaedics (Flynn, 2005), kidney disease (Coleman et al., 2017), community medicine (Kant et al., 2018) and arthritis care (Garner et al., 2017). This review highlights the need for research with thorough methodologies, focused on outcomes, to inform evidence‐based decisions.…”

“…The level of evidence and lack of experimental trials in other types of nurse practitioner-led clinics have been identified in various systematic reviews whereby firm conclusions could not be drawn and more research was warranted (Leonard, 2006;Shah & Deswal, 2016;Whiteford et al, 2016). Mullins et al (2016) (Flynn, 2005), kidney disease (Coleman et al, 2017), community medicine (Kant et al, 2018) and arthritis care (Garner et al, 2017). This review highlights the need for research with thorough methodologies, focused on outcomes, to inform evidence-based decisions.…”

Meeting patients where they are: improving outcomes in early chronic kidney disease with tailored self-management support (the CKD-SMS study)

“…Yet we acknowledge the systems barriers to change that reduce uptake of person-centred innovation in healthcare [ 66 ]. There are opportunities for this intervention to be delivered at existing nurse-led CKD clinics (e.g., [ 67 ]), or by nurses alongside routine clinical appointments at outpatient clinics. There is also potential for practices such as this to attract additional funding, with the current international focus on PCC in healthcare practice [ 68 , 69 ].…”

An integrated chronic disease nurse practitioner clinic: Service model description and patient profile

“…Due to the growing burden of chronic disease, across Australia there are an increasing number of nurse practitioner-led clinics conducted in public hospital outpatient departments or community healthcare centres although these clinics tend to align with the medical specialty model of service delivery. Nevertheless, nurse practitioner-led services are delivering on the triple aim of healthcare transformationenhancing patient experience, improving population health and reducing costs-while building future workforce capacity for integrated care (Coleman et al, 2017;Craswell et al, 2018;Douglas et al, 2018). This paper describes a novel, community-based Integrated Chronic Disease Nurse Practitioner (ICDNP) clinic and profiles the patient characteristics and clinical targets at entry to the clinic.…”