Degree Name
Nursing Practice, DNP
Publication Date
2-24-2026
First Advisor
Sandra King
Second Advisor
Veronica Arredondo
Abstract
Diabetic nephropathy is a major microvascular complication and the leading cause of chronic kidney disease (CKD) among individuals with diabetes. Children and adolescents with type 1 and type 2 diabetes face a higher risk of developing CKD earlier in life due to longer disease duration, poor glycemic control, and delayed CKD diagnosis. Guidelines emphasize timely detection and intervention to slow disease progression. Albuminuria is an early marker of glomerular injury and signals the need to initiate CKD treatment. Despite evidence supporting early detection and treatment, standardized management of albuminuria in pediatric diabetes care remains inconsistent. This Doctor of Nursing Practice quality improvement project aimed to address gaps in the management of albuminuria at a pediatric diabetes center. The project evaluated whether implementing an evidence-based albuminuria management protocol, along with an educational session, would increase healthcare providers’ self-confidence in managing albuminuria compared with current practices over two months. The project followed the Plan-Do-Study-Act framework, Kotter’s Change Theory, and the IOWA Revised Evidence-Based Model. A quasi-experimental design was used to assess the intervention's impact on physicians, nurse practitioners, and physician assistants delivering diabetes care. Provider self-confidence was measured using a validated Likert-scale survey administered before and after the intervention. A paired t-test showed a statistically significant increase in provider confidence scores after the intervention [N = 18; t(17) = -3.35, p = .004]. These results suggest that structured education and evidence-based protocols may enhance provider confidence, reduce practice variability, and optimize CKD outcomes in youth with diabetes.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Vakharia, Mili, "Quality Improvement Project: Protecting Young Kidneys: Optimizing Albuminuria Management in Youth with Diabetes" (2026). Doctor of Nursing Practice Projects. 296.
https://arch.astate.edu/dnp-projects/296
