Hypertensive Chronic Kidney Disease Identification in Primary Care: A Convergent Parallel Mixed-Methods Single Embedded Case Study

Abstract

University of Washington Abstract Hypertensive Chronic Kidney Disease Identification in Primary Care: A Convergent Parallel Mixed-Methods Single Embedded Case Study Sarah Llewellyn Chair of the Supervisory Committee: Barbara Cochrane School of Nursing Screening rates for chronic kidney disease in high risk populations are low, leading to late diagnoses and poor patient outcomes. The goal of this dissertation was to further explore contributing factors or barriers to screening for CKD in high risk populations in primary care settings. The statement of the problem and literature review highlight the need for improvement in screening rates and offer a foundation for the three studies subsequently presented. The first study, a scoping review, was guided by the question, “How has the Chronic Care Model or its elements been applied in interventions for CKD identification or management in primary care settings, and to what degree of success?” The second study, a mixed-methods case study further explored the practices and contextual factors that are related to primary care CKD screening in a cohort of young men with hypertension within one academic medical center organization. The final study, a secondary analysis, aimed to describe current CKD guideline uptake in primary care practice related to screening and antihypertensive medication use. The dissertation concludes with overall implications for future nursing practice and research.