Graduation Semester and Year

Spring 2025

Language

English

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Cathy Brown, DNP, RN, AGPCNP-BC, CNS

Second Advisor

Dr. Yungfei Kao

Abstract

Background: Social determinants of health (SDOH) and health literacy directly impact adults with end-stage renal disease (ESRD) on hemodialysis (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2022; Ulrich, 2020). Adults with ESRD account for 1.5 million hospital admissions and 500,000 re-admissions within 30 days annually (NIDDK, 2022). Case management is essential in reducing re-admissions for adult ESRD patients, requiring abilities to identify factors affecting adult ESRD patients appropriately.

Methods: Therefore, an evidence-based practice (EBP) project using the IOWA Model framework was implemented to increase the knowledge base in identifying care and resources for ESRD patients for telephonic nurse case managers working in a remote setting in metropolitan and rural counties in Texas. The SDOH survey assessed the nurse case managers' general knowledge and ability to assess SDOH pre/post-intervention.

Results: The project used a paired sample t-test to calculate the dependent samples of two sets of repeated measures data. The paired t-test = 4.991 for spatial orientation, a statistically significant result since p < .001, which is less than a = .05, d = 1.664. The mean of the pretest was 23.33, and the mean of the post-test score was 16.76. The evidence shows that the intervention significantly improved the nurse case managers survey scores.

Conclusion: Improving the knowledge base of case managers in assessing and identifying SDOH and health literacy deficits for adults with ESRD will decrease admissions and re-admissions by correctly identifying needs and referring to interdisciplinary team members such as social workers, pharmacists, and dieticians providing the resources.

Keywords

end-stage renal disease, hemodialysis, social determinants of health, health literacy, case managers, assessment

Disciplines

Other Nursing

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Included in

Other Nursing Commons

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