Capstone Paper Kidney failure

Type: BSN Capstone Project

Subject: Issues in Nursing

Subject area: Nursing

Education Level: Masters Program

Length: 15 pages

Referencing style: MLA

Preferred English: US English

Spacing Option: Double

Additional information

Title: Hi just wanted to update my topic to diabetes in pregnancy.

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Name:  Mhawa Soumah

Course: RN BSN Program

Affiliation: Hosanna College of Health

Date of Submission 

Kidney Failure

1. Abstract 

Kidney failure continues to be one of the most common medical conditions affecting Americans with the largest number coming from the minority groups such as the Latinos and the Hispanic communities. Most of these families have reported a member of a family dying or experiencing complications related to the disease. Various studies have attributed the growing cases of kidney failure in these communities to poverty, limited education and poor English proficiency which in return prevents the community members from coming up with a kidney failure campaign in a manner that can ensure these members of the community understand the disease. 

The purpose of this capstone project was to find out whether the implementation of education intervention campaigns among the Hispanic communities can increase knowledge on Kidney failure among eh Hispanic communities in the United States. The focus are the patients diagnosed with stage three and stage four kidney disease from community hospitals to ensure that they are able to understand  their kidney health and management. 

The methodology of this capstone will be a mixed method, where both the quantitative and qualitative data will be used. A literature review will also be conducted from pertinent health information literature like the National Kidney foundation, the CDC, the American diabetes association and other evidence based research. The study, aim is to prove that when people in the community are provided with education and resources in the design and language that they understand, the can be more involved in their health and wellbeing, they will be more receptive to learning and be active in the management of their condition. Due to budgetary constraints, interviews were carried through virtual technology of zoom. The capstone project shows that there is continued need to ensure free and culturally appropriate education regarding kidney failure including conducting health screenings. 

Introduction 

kidney failure is a severe consequence of chronic disease that has been acknowledged as such by the World Health Organization (WHO) (National Kidney Foundation, 2022). This is owing to the influence that Kidney Failure has on morbidity and mortality. In addition, the high expense of treating Kidney Failure  has elevated it to a position of importance in the field of medicin (Center for Disease Control, 2022) e. The Center for Disease Control and Prevention (CDC) estimates that 26 million persons are living with chronic kidney disease, which is a degenerative condition that is, for the most part, quiet and undetected. Kidney illness that persists over time (Center for Disease Control, 2022).

Education is not only necessary but also a vital component in order to encourage patients' empowerment and self-management, which is ultimately beneficial for the patient as a whole. Education of the patient can help to delay the advancement of Kidney Failure to end-stage renal disease (ESRD) by learning ways to lower the risk of complications associated with advanced illness, lowering the total expense and burden, and improving the patient's general health.

Patients are referred to and examined at a big clinic located in the Hispanic areas for the treatment of hypertension, electrolyte imbalances, fluid management, and Kidney Failure. During the course of treating patients, it becomes apparent that there is a knowledge gap concerning patients who had been given a diagnosis of Kidney Failure (Langham et al., 2022). In this study thus, the primary investigator had the belief that a kidney disease education program, which was evidence-based and structured, would be beneficial.

Class could help close the education and perceived information gaps about the disease, which would lead to better understanding and management of the condition. In the context of this project, Kidney Failure is defined as a disorder that is characterized by a progressive loss of the kidneys' ability to adequately filter harmful substances and waste products out of the blood. Chronic renal disease is characterized by structural or functional abnormalities of the kidney that have persisted for at least three months but not more than one year. This shows up as damage to the kidneys, with or without a corresponding drop in the estimated glomerular filtration rate (eGFR).

According to statistics provided by the American Journal of Preventive Medicine, the percentage of people who are aware of  Kidney Failure stands at 9% overall and 9.3% in the state of California, which can relate to other communities where there is a high population of the Hispanic and Latino population (Kula et al., 2021). There is a reduction in mortality, complications, and disease progression towards end-stage renal disease among patients who are aware of their kidney illness and the risk factors connected with the disease (Langham et al., 2022). Multiple studies have shown that low socio-economic groups, such as Hispanics and Latinos living in the United States, have a lower disease awareness or are unaware of their Kidney Failure status. Furthermore, the disease progresses more quickly in Hispanics and Latinos when compared to other ethnic groups living in the United States.

There are some people in the United States who do not consider going to the doctor as an issue or a concern. Sadly, many Hispanics and Latinos who live in the United States may find that this is a barrier for them. According to Kula et al., (2021) Hispanics and Latinos face obstacles that prohibit them from obtaining healthcare services. This can lead to a reduction in disease awareness and management. The lack of education, poverty, low reading levels, and an inability to understand or speak English were the types of impediments that were mentioned most frequently in relation to this population. This vulnerable demographic may also lack health insurance or may reside in places with limited access to medical treatment, making them even more susceptible to adverse health outcomes.

There is a need for a chronic disease campaign to address the problems that are caused by the low level of disease awareness and the fact that English is a barrier for many Hispanic and Latino people who live in the United States. In San Francisco County for example, Hispanics and Latinos make up 15.2% of the population, and in San Francisco's Mission District (a neighborhood with Hispanic and Latino roots), 19,456 Hispanics, and Latinos living there have limited English proficiency (Kula et al., 2021). The Mission District is a neighborhood with Hispanic and Latino roots. The Hispanic and Latino community that resides in the Mission district of San Francisco can benefit from a Kidney failure Kidney Failure awareness campaign that, in addition to offering Spanish-language health education and screenings for kidney disease, can also help reduce mortality rates and improve overall health.

Awareness of Kidney Failure as well as management of existing diabetes and high blood pressure is essential for preventing disease complications in this vulnerable population. Despite this, many Hispanics and Latinos face barriers that prevent them from seeking preventative care and necessary screening (Desai et al., 2019). Patients will be encouraged to seek assistance, get further illness knowledge, and participate in their own disease management and prevention efforts if there is a greater awareness of Kidney Failure and the conditions that cause it. Multiple studies have come to the conclusion that when adults are aware of their illness state (for example, high blood pressure, diabetes, or kidney disease), they are better able to regulate their disease, which either stops or slows the progression of Kidney Failure. Many organizations are blazing new trails in the development of new approaches to assist and communicate with vulnerable Hispanic and Latino populations in order to address the myriad of obstacles (including low disease awareness, limited education, poverty, low reading levels, and low English proficiency) that prevent Hispanics and Latinos from having to know their disease status.

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Also Read: High-quality Nursing Capstone Project Help For Students

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2. Literature review

Desai et al., (2019), in a qualitative study reports that, In spite of the fact that Hispanics make up the biggest racial and ethnic minority group in the United States, they bear a disproportionately high burden of renal disease. Despite the fact that the prevalence of Kidney Failure is comparable to or slightly lower in Hispanics than it is in non-Hispanic whites, the prevalence rate of end-stage renal disease is almost fifty percent higher in Hispanics than it is in non-Hispanic whites when age and gender are taken into account. One possible explanation for this is that Hispanics experience a more rapid progression of chronic kidney disease. In addition, research has shown that Hispanic ethnicity is linked to a higher prevalence of risk factors for cardiovascular disease, such as obesity and diabetes, in addition to issues related to Kidney Failure. The risk of mortality among Hispanics appears to be lower than that of non-Hispanic whites, despite the fact that Hispanics have a higher burden of comorbid conditions and a socioeconomic status that is less favorable than that of non-Hispanic whites, which often leads to limited access to quality health care. One possible explanation for this survival paradox is that it is the result of a complex interaction between sociocultural and psychosocial elements, in addition to other aspects. The long-term effects of these characteristics on patient-centered and clinical outcomes should be the primary focus of research that will be conducted in the future. Access to and the quality of health care for Hispanics with Kidney Failure must be improved through the implementation of national initiatives.

Kula et al., (2022)  in a quantitative study showed that There have been reports of significant racial and ethnic discrepancies in the outcomes of cardiovascular (CV) and kidney function tests in older persons diagnosed with Kidney Failure. However, there is a lack of information about the extent to which these differences are present in individuals who have Kidney Failure during the formative years of young adulthood. The purpose of this research was to compare the rates of progression of Kidney Failure and cardiovascular disease (CVD) among young adults who already had Kidney Failure from different racial and cultural backgrounds. The endpoints of the trial comprised cardiovascular (CV) events or mortality (first incidence of heart failure, myocardial infarction, and stroke or death), as well as progression of chronic renal disease (>50% drop in eGFR from baseline or end stage kidney disease [ESKD]). In a secondary study, participants who identified themselves as Black or Hispanic were contrasted with those who identified themselves as White or as members of another race or ethnicity. The comparison was made using incidence rate ratios, or IRRs. The models were adjusted to include age, gender, and the presence or absence of the APOL1 high-risk allele. The average systolic blood pressure, body mass index, median unsaturated triglyceride level, and low-density lipoprotein levels were all greater in Hispanic and Black subjects. In this study, participants who were Black or Hispanic had higher incidence rates of heart failure (17.5 compared 5.1/1000 person-years), overall mortality (15.2 against 7.1/1000 person-years), and progression of Kidney faliure(125 versus 59/1000 person-years). This demonstrated that young persons who identify as Black or Hispanic and have Kidney Failure are more likely to have a higher prevalence of cardiovascular risk factors, some of which are controllable. The development of future initiatives to address the racial and ethnic disparities that exist earlier in life in terms of patients' health outcomes due to Kidney Failure should be highlighted.

Kula et al., (2021) in an observational study, demonstrated that the treatment and monitoring of blood pressure is a significant modifiable risk factor for cardiovascular events and the progression of Kidney Failure in persons middle-aged or older who have Kidney Failure. However, there are not a lot of research that describe the connection between blood pressure and the outcomes in young individuals who have Kidney Failure. The participants of this study were 317 young adults (aged 21-40 years) who were enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. These participants had mild to moderate Kidney Failure. In the exposures, systolic blood pressure at baseline was assessed both continuously (every 10 mm Hg increase) and in categories (less than 120, between 120 and 129, and more than 130 mm Hg). The primary outcomes were cardiovascular events (heart failure, myocardial infarction, stroke, or death from any cause) and development of Kidney Failure; defined as a 50% reduction in eGFR or ESKD). To investigate potential links between baseline systolic blood pressure and subsequent cardiovascular events and Kidney Failure progression, we employed Cox proportional hazard models. During the median follow-up intervals of 11.3 years and 4.1 years, respectively, 52 people experienced cardiovascular events, while 161 participants saw development of their Kidney Failure. Among those who had a baseline systolic blood pressure of less than 130 mm Hg, three percent per year got heart failure, twenty percent per year saw progression of Kidney Failure, and two percent per year passed away. Baseline systolic blood pressure greater than 130 mm Hg, as compared to systolic blood pressure less than 120 mm Hg, was significantly associated with cardiovascular events or death (hazard ratio [HR], 2.13; 95% confidence interval [95% CI], 1.05 to 4.32) and Kidney Failure progression (hazard ratio [HR], 1.68; 95% confidence interval [95% CI], 1.10 to 2.58) in models that were fully adjusted. The researchers came to the conclusion that a higher systolic blood pressure is strongly associated with a greater risk of cardiovascular events and Kidney Failure development in young adults who have Kidney Failure. It is necessary to conduct trials of blood pressure control in order to assess specific therapy targets and techniques in young adults who have.

Langham et al., (2022),  was of the view that  high burden of kidney disease, the global inequities in kidney care, and the dismal outcomes of kidney failure bring a concomitant expanding burden to individuals affected by the disease, their families, and caregivers, as well as the community as a whole. Health literacy can be defined as the degree to which individuals and organizations possess or enable individuals to have the ability to locate, comprehend, and use information and services in order to make informed decisions and actions pertaining to their own and others' health for themselves and for others. Instead of perceiving a lack of health literacy as a shortcoming on the part of the patient, enhancing health literacy is mostly dependent on health care workers effectively communicating and educating persons who have renal disease in code signed cooperation with those affected by the condition. The requirement to transform organizations into cultures that put the patient at the heart of their health care is presented to decision-makers in the kidney policy field by the concept of health literacy. All of the parties involved can benefit from new chances to improve their education and awareness of renal illness because to the expanding capabilities and accessibility of technology. The advancements in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education. The World Kidney Day has declared the year 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney groups need to make it their mission to change the narrative that patients have a lack of health literacy and make it clear that improving health literacy is the responsibility of health care providers and policymakers. The renal community works toward the goal of preventing kidney diseases and enabling healthy living with kidney disease by participating in and supporting kidney health-centered policy making, community health planning, and health literacy initiatives for all.

Taylor et al., (2017) in a systematic review study found that People with Kidney Failure have a 25% higher risk of having insufficient health literacy, which may lead to reduced self-management abilities and ultimately poorer clinical results. Lack of health literacy may contribute to health inequity since it has a disproportionate impact on persons with lower socioeconomic level and people of non-white ethnicity. There is a lack of sufficient evidence to support the assertion that health literacy has a direct and significant influence on patient outcomes in Kidney Failure. The evidence that is now available points to links with unfavorable clinical events, higher utilization of healthcare services, and mortality. Prospective studies are required to determine the causal effects of health literacy on outcomes in Kidney Failure patients and to examine the association between socioeconomic status, comorbidity, health literacy, and outcomes. Additionally, it is necessary to determine whether or not health literacy can be used to predict Kidney Failure outcomes. The creation and evaluation of interventions will determine whether or not low health literacy is a controllable determinant of poor outcomes in Kidney Failure

3. Methods and Material

The study incorporated the use of both qualitative and quantitative data. Quantitative analysis is the manipulation of numerical data by using statistical methods with the goal of either describing phenomena or evaluating the significance as well as the dependability of the connections between them. In this regard thus, a mixed method of study was carried out with the hospital setting. Study participants were recruited from one clinic that served a large patient population and one office that served a smaller patient group. After receiving notification from the assistant primary investigator, the principal investigator was able to safely secure the study participants. When a patient presented themselves for their first appointment with a nephrologist, the practice medical receptionist would say the following:

Having a diagnosis of Kidney failure in stage III or stage IV. The primary investigator got in touch with the participant candidate providing background information on the study After going through the information page, every question was answered. Assuming the patient's concerns were resolved and they decided to take part in the trial, a serial identifying number for the

The patient was put into one of two groups: the control group or the experimental group. The initial PIKS survey was carried out in finished at that point in time In the event that the primary investigator was unable to participate, a clinical research assistant the patient was given an explanation of the study by a staff member who was specifically trained by the primary investigator. Research while providing answers to any questions. At the time of their first referral, study participants filled out the questionnaire. Appointment as well as the patient's subsequent appointment for follow-up care. The patient reported during the follow-up appointment that the patient had the serial identification number, which identified the patient as a study participant. Participants in the survey, which was finished The results of this study's data collection were examined using descriptive statistics as well as independent a samples t-test was performed on the dependent means to determine whether or not there was a statistically significant relationship between the after having participated in the education intervention sessions, the experimental group. The study results  instrument's  were entered into an Excel spreadsheet for analysis as a means of measuring the outcomes.

For one to facilitate organizing, followed by the entry of this data into the Statistical Software for the Social data analysis using the Statistical Package for the Social Sciences, version 23 (SPSS v. 23).

Results 

According to the findings of the study, there is a need for further investigation, such as a longitudinal study investigation with a bigger sample size to identify any significant changes, validate findings, and draw conclusions from the findings and definitive conclusions. There are two distinct types of statistical procedures that could offer supplementary insight. An analysis of variance that combines randomized and repeated samples is being done to look at the true effects of the treatment. (ANOVA) to determine whether the degree of difference in scores between before and after the intervention is significant. Affected patients differently depending on whether they were part of the experimental group, the control group, or neither group at all.

an analysis of covariance (ANCOVA), using the pre-test scores as the variable being analyzed. Moving onward and upward with both prospective and retrospective investigations, it would be possible to evaluate endpoints like biomarkers in the kidneys, maintenance of electrolyte balance, regulation of blood pressure, and a reduction in hospitalizations, as well as increased awareness of Kidney failureboth before and after the education programs were implemented. . Kidney failure is a progressive illness that is a major factor in the development of chronic disease overall. The overall rate of sickness and death in this country. Throughout this entire process, there are numerous educational opportunities. The network that will aid patients earlier on in the disease process in order to improve the gap in education and perception of one's familiarity with kidney failure.  The maintenance of a purposeful and consistent standardization throughout.

All patients within the Hispanic community will gain benefits from educational programs such as the education intervention employed in this project, which will expand their understanding and make it easier for them to manage their conditions on their own. Through a deeper comprehension of the pathophysiology of the disease. Despite the limited amount of time that was available for this study, the results of the investigation showed promising statistically significant differences before and after educational intervention. 

In regard to the project, it would thus be encourage the establishment of a Kidney failureeducational policy that is implemented across the network, making use of the Every patient who has been diagnosed with Kidney failure should participate in education intervention as a standard component of comprehensive medical care. This educational policy could help enhance patient education if it were implemented. It would be the solution to the problem of inadequate awareness and the advancement of kidney failure by filling in the gaps in our knowledge in order to gain a deeper comprehension, providing assistance with illness management in order to get better clinical results, offering the possibility of delaying the progression of kidney failure to end-stage renal disease (ESRD) and bringing down the overall cost of medical care

This project thus paves the path for additional research to be conducted within the nephology clinic in the future. With the inclusion of a nurse navigator or social worker specializing in kidney failure, these significant additions are vital. The healthcare team that specializes in nephrology may be able to aid with increased treatment compliance. 

Increased patient satisfaction due to enhanced communication between patients and nephrologists and a decrease in patient The individual's view of their own health or condition, missing appointments, and disobedience with medicine are all examples of hurdles. A lack of access to means of transportation, emotional support, and financial support, as well as the requirement for continuing support education. This diagnosis is significant due to the high rates of morbidity and mortality as well as the financial burden associated with kidney failure. A top priority in terms of health care. Educational intervention programs, particularly when the curriculum is tailored to the individual to the disease process, are essential for improving patient outcomes in accordance with the research that has been done, and monitoring of particular endpoints, as was covered before in this section. 

The results obtained from this culminating project have repercussions for nursing practices that take place within the context of a nephrology clinic. Having an understanding of the Patients' educational, emotional, and social needs, in addition to the obstacles that prevent them from complying with treatment recommendations makes it possible to build programs that encourage treatment compliance, self-management, and self-efficacy comes out on top in the end. To say that the job of the lead investigator is critical would be an understatement. By sharing the results of the study, the nurse can help encourage a change in the educational approach that is now being used for kidney failure. study in a manner that is understandable and not ambiguous to the nephrologists, primary care physicians, and other stakeholders. process; according to the model presented by the project process.

Limitations: 

The main limitation for this study was language barrier where some of the participants were not able to speak fluent English thus posing a barrier to the implementation of the project. There was also technological barrier since some of the interviews were carried virtually and there were paticipants not conversant with the technology. 

4. Discussion 

As can be shown from the outcomes of my kidney failure education intervention, the Hispanic and Latino population does indeed participate in health educational workshops when they are offered. This campaign provides evidence to support the contention that Hispanic and Latino populations require an increase in the number of health education interventions to reduce the risk of additional health-related issues. There are a number of organizations that already serve the Hispanic and Latino community that have the potential to form partnerships with other organizations, such as KDSAP, healthcare organizations, and others, in order to improve the Hispanic and Latino population's overall health. Due to limited poverty levels it was found that organisations also use Tele-Health, apps that monitor health status, and by continuing to provide free educational resources through video platforms such as Zoom.

As was indicated earlier, numerous scholars have proposed that we make use of a variety of approaches to health communication in order to assist in the education of people in need and to communicate crucial health information to such communities. We will be able to assist members of the Hispanic and Latino community in leading healthier lives if we make use of pictorial aids, group educational sessions,  automated phone call reminders, and audiovisuals.

5. Conclusion 

In summary, based on the project, if there are no interventions, the Hispanic and Latino population in the United States, which is the largest minority group in the country, will continue to be affected by kidney failure as a deadly disease. According to the National Kidney Foundation (2020), Hispanics and Latinos frequently receive a diagnosis of kidney failure  in the later stages of the disease, at which point it is frequently too late to reverse the disease or halt it from advancing into kidney failure.

As can be seen from this project and the existing body of literature, there is still a significant demand for free educational workshops and health screenings that are culturally and linguistically appropriate. Nevertheless, additional grants and funding are required to finance these and other future public health events. When members of the community are given the opportunity to participate in educational workshops, they listen attentively to the knowledge that is shared with them. The results of the Campaign are promising, however, future barrier events will continue to bring many challenges to how health information is delivered. As nurses working with the community, there is need for more training to teach communities about nutrition, our liver, our heart, and everything, to help us stay healthy. . The kidney failure  capstone project thus provided encouraging evidence education interventions has the potential to be an invaluable resource for the dissemination of future health information.

In addition, if we do not take action to address the problem, low health literacy, and low English proficiency will continue to be a barrier. It should be noted that inadequate English proficiency, which includes ability to read instructions or prescriptions,  is not just a problem in San Francisco; it is a problem all across the United States. 

References

Center for Disease Control. (2022, February 18). Chronic kidney disease is increasing in Mexican Americans. Centers for Disease Control and Prevention. https://www.cdc.gov/kidneydisease/publications-resources/ckd-increase-mexican.html

Desai, N., Lora, C. M., Lash, J. P., & Ricardo, A. C. (2019). CKD and ESRD in US Hispanics. American Journal of Kidney Diseases, 73(1), 102-111. https://doi.org/10.1053/j.ajkd.2018.02.354

Dinh, H. T., Nguyen, N. T., & Bonner, A. (2021). Healthcare systems and professionals are key to improving health literacy in chronic kidney disease. Journal of Renal Care, 48(1), 4-13. https://doi.org/10.1111/jorc.12395

Kula, A. J., Prince, D. K., Flynn, J. T., & Bansal, N. (2021). BP in young adults with CKD and associations with cardiovascular events and decline in kidney function. Journal of the American Society of Nephrology, 32(5), 1200-1209. https://doi.org/10.1681/asn.2020081156

Kula, A. J., Prince, D. K., Limonte, C. P., Young, B. A., & Bansal, N. (2022). Rates of cardiovascular disease and CKD progression in young adults with CKD across race/Ethnic groups. Kidney360, 10.34067/KID.0006712021. https://doi.org/10.34067/kid.0006712021

Langham, R. G., Kalantar-Zadeh, K., Bonner, A., Balducci, A., Hsiao, L., Kumaraswami, L. A., Laffin, P., Liakopoulos, V., Saadi, G., Tantisattamo, E., Ulasi, I., Lui, S., Langham, R. G., Kalantar-Zadeh, K., Balducci, A., Hsiao, L., Kumaraswami, L., Laffin, P., Liakopoulos, V., … Lui, S. (2022). Kidney health for all: Bridging the gap in kidney health education and literacy. Kidney International, 101(3), 432-440. https://doi.org/10.1016/j.kint.2021.12.017

National Kidney Foundation. (2022, February 19). Race, ethnicity, & kidney disease. https://www.kidney.org/atoz/content/minorities-KD

Taylor, D. M., Fraser, S., Dudley, C., Oniscu, G. C., Tomson, C., Ravanan, R., & Roderick, P. (2017). Health literacy and patient outcomes in chronic kidney disease: A systematic review. Nephrology Dialysis Transplantation. https://doi.org/10.1093/ndt/gfx293