Establishing the suitability of an instrument that determined advanced practice registered nurses’ baseline knowledge of chronic kidney disease practice guidelines

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Shernett M. Chung (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Eileen Kohlenberg

Abstract: Background: Chronic kidney disease (CKD) is the eighth leading cause of US deaths, requiring dialysis or kidney transplant at end-stage. Poor knowledge of CKD among physicians and patients contributes to early deaths and avoidable complications, but non-Nephrology adult health Advanced Practice Registered Nurses (APRN) have not been studied similarly, although they are important in addressing the physician shortage. Objective: This study examined a 15-item instrument that was designed to assess physicians’ knowledge of CKD practice guidelines, for its suitability with non-nephrology APRNs. Methods: An online survey of APRNs (n = 254) was administered over a three-week period. Exploratory Factor Analysis (EFA) examined the factor structure and the relatedness of the items to the derived factors and Pearson’s Chi-square test of independence examined associations between scores and the APRN descriptors. Results: Cronbach’s alpha was .71 overall, and below .69 for the subscales. The EFA five-factor solution explained 52% of the variance. There were statistically significant (p < .05) associations between the scores (M = 29.44, SD = 6.26) and descriptors. Over 55% of the APRNs worked in specialty areas outside of Internal and Family Medicine, did not practice independently, and relied on team members to handle complex cases like CKD. Conclusion: The Physicians’ instrument had excellent face validity. It was inadequate for determining baseline knowledge of CKD practice guidelines among APRNs in this study, the majority of whom reported that they did not diagnose or treat CKD cases, hence there was no need for them to have an in-depth knowledge of CKD guidelines. Based on the results, an unvalidated 12-item alternative scale was developed for non-Nephrology APRNs practicing outside of primary care, to demonstrate that knowledge of the guidelines can be assessed without complex CKD-specific jargon, staging, and laboratory values. The findings can inform Nursing Education curricula and generate nursing research and instrument development that targets APRNs. Keywords: Advanced Practice Registered Nurse, chronic kidney disease, CKD Belt, content analysis, exploratory factor analysis, knowledge of CKD practice guidelines, Knowles’ theory of adult learning, parallel analysis

Additional Information

Language: English
Date: 2021
Advanced Practice Registered Nurse, CKD Belt, Content analysis, Exploratory factor analysis, Knowledge of CKD practice guidelines, Knowles’ theory of adult learning
Chronic renal failure $x Nursing
Nursing $x Ability testing
Examinations $x Validity

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