Degree Name
Nursing Practice, DNP
Publication Date
9-28-2026
First Advisor
Sandy King
Second Advisor
Alisha McAfee
Abstract
Chronic kidney disease (CKD) is a common complication of diabetes. Evidence-based guidelines recommend urine albumin-to-creatinine ratio (UACR) screening for early identification of albuminuria in patients with diabetes; however, screening was inconsistently completed in an outpatient primary care clinic. This quality improvement project evaluated the impact of a standardized, provider-focused intervention on UACR screening completion and therapy intensification in patients with microalbuminuria. The Iowa Model served as the evidence-based practice framework, Lewin’s Change Theory provided the theoretical framework for practice change, and the Plan-Do-Study-Act cycle guided implementation and evaluation. A quasi-experimental pre- and post-intervention design was used. The intervention was delivered to primary care providers caring for adults with diabetes and consisted of education on CKD screening recommendations and implementation of a standardized UACR screening tool. Clinical outcomes were collected through retrospective reviews of separate random samples of 100 patient charts before and after implementation using a project-specific chart-review tool. The supervising physician and site medical director reviewed the tool to support content validity with kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Chi-square tests of independence showed that UACR completion among patients due for screening increased from 33 of 81 (40.7%) to 72 of 80 (90.0%), p < .001. SGLT2 inhibitor use increased from 14% to 33% (p = .002). Limitations included the single-site design, short implementation period, and small provider sample. Findings support standardized, provider-focused processes to strengthen CKD screening and evidence-based management.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Easow, Binsy, "Quality Improvement Project: Early Screening for Kidney Disease in Primary Care Clinics" (2026). Doctor of Nursing Practice Projects. 383.
https://arch.astate.edu/dnp-projects/383
