Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses

Sinclair, PM; Day, J; Levett-Jones, T; Kable, A

Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses

Sinclair, PM Day, J Levett-Jones, T

Kable, A

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Publication Type:: Journal Article
Citation:: Nephrology, 2017, 22 (10), pp. 776 - 782
Issue Date:: 2017-10-01

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Field	Value	Language
dc.contributor.author	Sinclair, PM	en_US
dc.contributor.author	Day, J	en_US
dc.contributor.author	Levett-Jones, T https://orcid.org/0000-0003-4279-8957	en_US
dc.contributor.author	Kable, A	en_US
dc.date.available	2016-07-12	en_US
dc.date.issued	2017-10-01	en_US
dc.identifier.citation	Nephrology, 2017, 22 (10), pp. 776 - 782	en_US
dc.identifier.issn	1320-5358	en_US
dc.identifier.uri	http://hdl.handle.net/10453/123321
dc.description.abstract	© 2016 Asian Pacific Society of Nephrology Aim: Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia. Methods: An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses. Results: Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence. Conclusion: The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.	en_US
dc.relation.ispartof	Nephrology	en_US
dc.relation.isbasedon	10.1111/nep.12856	en_US
dc.subject.classification	Urology & Nephrology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Mass Screening	en_US
dc.subject.mesh	Early Diagnosis	en_US
dc.subject.mesh	Predictive Value of Tests	en_US
dc.subject.mesh	Attitude of Health Personnel	en_US
dc.subject.mesh	Health Knowledge, Attitudes, Practice	en_US
dc.subject.mesh	Nurse's Role	en_US
dc.subject.mesh	Physician-Nurse Relations	en_US
dc.subject.mesh	Qualitative Research	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	Cost Savings	en_US
dc.subject.mesh	Health Care Costs	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Renal Insufficiency, Chronic	en_US
dc.subject.mesh	General Practice	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.title	Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	22	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	22	en_US

Abstract:

© 2016 Asian Pacific Society of Nephrology Aim: Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia. Methods: An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses. Results: Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence. Conclusion: The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.

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http://hdl.handle.net/10453/123321