Côté Jean-Maxime, Beaubien-Souligny William, Hamel Lauriane, Bouchard Josée
Centre de recherche du Centre hospitalier de l'Université de Montréal, QC, Canada.
Division of Nephrology, Centre hospitalier de l'Université de Montréal, QC, Canada.
Can J Kidney Health Dis. 2024 Dec 13;11:20543581241304517. doi: 10.1177/20543581241304517. eCollection 2024.
Patients who experienced acute kidney injury (AKI) may benefit from dedicated care following hospital discharge. Most of these patients will be followed by primary care providers. There is a lack of data on current practices and comfort for these care providers when offering post-AKI care.
We surveyed nurse practitioners and family physicians to assess their awareness, perceptions, practice patterns and comfort regarding post-AKI care.
DESIGN/SETTING: We distributed a web-based self-administered survey among clinicians from the Province of Quebec. We asked about their awareness and perceptions on how AKI should be disclosed and followed, the barriers encountered regarding the process of care following hospital discharge, and their level of comfort and expertise in offering dedicated post-AKI care. The survey integrated direct and scenario-based questions and was conducted from December 2022 to April 2023.
We distributed the survey to practicing family physicians and nurse practitioners through the mailing list of the , and the , respectively. No incentives were provided.
We conducted descriptive analyses and used chi-squared analysis to compare responses between family physicians and nurse practitioners and between hospital-based and cabinet-based practice.
The survey was opened by 779 potential participants. Of these, the response rate was 9% (70/779). Most participants were family physicians (79%) and dedicated 70% (±32) of their time in community outpatient clinics. Participants reported that 59% (±20) of all patients seen daily had at least 1 risk factor for AKI, whereas they estimated that 21% (±12) of recently discharged patients suffered from an AKI episode. The lack of awareness by the patient and lack of details on the discharge summary were the barriers most frequently reported impacting the overall process of care at follow-up. Most nurse practitioners (60%) and 33% of family physicians reported at least some levels of discomfort and lack of expertise when offering post-AKI.
The generalizability of our study is limited by its response rate. However, this is comparable with typical response rates seen in electronic surveys. The distribution was limited to a single province of Canada.
We reported significant barriers regarding the hospital-to-community transition of care in patients who experienced AKI and the suboptimal comfort and expertise of primary care providers when offering dedicated post-AKI care. This reflects the need to improve communication, collaboration, and AKI training with primary care providers.
经历过急性肾损伤（AKI）的患者在出院后可能会从专门护理中受益。这些患者大多将由初级保健提供者进行随访。目前缺乏关于这些护理提供者在提供急性肾损伤后护理时的现行做法和舒适度的数据。
我们对执业护士和家庭医生进行了调查，以评估他们对急性肾损伤后护理的认识、看法、实践模式和舒适度。
设计/地点：我们在魁北克省的临床医生中开展了一项基于网络的自我管理调查。我们询问了他们对急性肾损伤应如何告知和随访的认识和看法、出院后护理过程中遇到的障碍，以及他们在提供专门的急性肾损伤后护理方面的舒适度和专业水平。该调查综合了直接问题和基于情景的问题，于2022年12月至2023年4月进行。
我们分别通过[具体机构1]和[具体机构2]的邮件列表，将调查问卷分发给执业家庭医生和执业护士。未提供激励措施。
我们进行了描述性分析，并使用卡方分析来比较家庭医生和执业护士之间以及医院执业和诊所执业之间的回答。
779名潜在参与者打开了调查问卷。其中，回复率为9%（70/779）。大多数参与者是家庭医生（79%），并且他们70%（±32）的时间用于社区门诊。参与者报告称，他们每天接诊的所有患者中有59%（±20）至少有1个急性肾损伤风险因素，而他们估计最近出院的患者中有21%（±12）经历过急性肾损伤发作。患者缺乏认识以及出院小结缺乏细节是最常报告的影响随访护理整体过程的障碍。大多数执业护士（60%）和33%的家庭医生报告在提供急性肾损伤后护理时至少有一定程度的不适和缺乏专业知识。
我们研究的可推广性受到其回复率的限制。然而，这与电子调查中常见的典型回复率相当。调查范围仅限于加拿大的一个省份。
我们报告了急性肾损伤患者在医院到社区护理过渡方面存在重大障碍，以及初级保健提供者在提供专门的急性肾损伤后护理时舒适度和专业水平欠佳。这反映出需要改善与初级保健提供者的沟通、协作以及急性肾损伤培训。
