Kimmitt Robert, Leonard Hugh, Shivakumar Oshini, Storms Karen, Stansfield Rebecca, Hurst Helen, Donne Rosemary
Biomedical Sciences, University of Exeter, Exeter, UK.
Exeter Kidney Unit, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
BMJ Open. 2025 Mar 24;15(3):e096935. doi: 10.1136/bmjopen-2024-096935.
Multidisciplinary advanced kidney care (AKC) services provide care to patients with advanced chronic kidney disease (CKD) (typically estimated glomerular filtration rate (eGFR) ≤20 mls/min/1.73m), as symptoms and complications become more common, also in preparation for kidney failure treatments. Despite their prominence in UK renal services, there is no consensus around the best practice for AKC services in terms of care delivery models or interventions to optimise patient care, and there is widespread geographical variation in practice. The UK Kidney Association Kidney Quality Improvement Partnership has launched a 3-year 'Transform AKC' quality improvement project to address unmet needs in AKC services and work towards improvement. This scoping review is part of the Transform AKC project and aims to identify existing evidence for the current and best practice in AKC. The aim of this review is to establish any evidence that demonstrates best practice models of care and interventions to optimise care for adult patients with advanced CKD.
We will undertake a scoping review seeking to identify and evaluate evidence that demonstrated best practice for care of adults with advanced CKD. Databases (Medline and Embase) will be searched systematically (search dates from 1 January 2014 to 8 August 2024), and a final list of included studies will be analysed and synthesised.
We will use robust methodology to identify the existing literature describing the best practices in care of adults with advanced CKD. These findings will directly inform the 'Transform AKC' national quality improvement project, in which this scoping review is embedded. Findings will also be disseminated through national conferences and will be published in a relevant journal.
多学科晚期肾脏护理(AKC)服务为晚期慢性肾脏病(CKD)患者(通常估算肾小球滤过率(eGFR)≤20 ml/min/1.73m²)提供护理,随着症状和并发症变得更加常见,同时也为肾衰竭治疗做准备。尽管AKC服务在英国肾脏服务中占据重要地位,但在护理提供模式或优化患者护理的干预措施方面,对于AKC服务的最佳实践尚无共识,并且实践中存在广泛的地域差异。英国肾脏协会肾脏质量改进合作组织启动了一项为期三年的“变革AKC”质量改进项目,以满足AKC服务中未得到满足的需求并努力实现改进。本范围综述是“变革AKC”项目的一部分,旨在识别AKC当前和最佳实践的现有证据。本综述的目的是确定任何能够证明针对晚期CKD成年患者的最佳护理模式和优化护理的干预措施的证据。
我们将进行一项范围综述,旨在识别和评估能够证明晚期CKD成年患者最佳护理实践的证据。将系统检索数据库(Medline和Embase)(检索日期为2014年1月1日至2024年8月8日),并对纳入研究的最终列表进行分析和综合。
我们将使用可靠的方法来识别描述晚期CKD成年患者最佳护理实践的现有文献。这些发现将直接为“变革AKC”国家质量改进项目提供信息,本范围综述即嵌入该项目。研究结果还将通过全国性会议进行传播,并将发表在相关期刊上。