The role of Advanced Practice Nurses in creating the Kidney Transplant candidate care map (APN-preKT): a convergent-parallel mixed methods research protocol

Abstract

Background Waiting time for kidney transplants (KT) is an important health determinant for patients with chronic kidney disease (CKD). During this time, ongoing evaluation and participation is necessary in order to guarantee the quality and suitability of the proposed treatment. There is no existing literature on the potential impact of inclusion of an Advanced Practice Nurse (APN) role in the hospital setting on care for CKD patients who are candidates for KT. The main objectives of this protocol are: to analyse outpatient nursing activity in the care of individuals with KT in Spain; to identify the needs of individuals who are KT candidates; and to measure the impact of the APN role through patient outcomes and experiences. These objectives are fulfilled through 5 specific related substudies. Methods A convergent parallel mixed methods approach will be conducted between July 2021 and April 2024. Quantitative and qualitative data will be collected and analysed separately to ascertain whether the findings confirm or contradict one another. Each of the 5 substudies of the project require a specific design, sampling method, and data collection procedure in order to meet the overall objectives for the project. Discussion The results of the project are expected to inform the design of future nursing roles and contribute to future improvements in the quality of care provided. The data that may be obtained from this protocol are limited to the specific context of the study facility and may be extrapolated but not compared to other settings due to the variability of care pathways for KT candidates internationally. Trial registration This project was approved by the Clinical Research Ethics Committee (no.2020/9418/I). The study was supported by the “Strategic Plan for Health Research and Innovation” from the Generalitat de Catalunya, registration number SLT017/20/000001, with a contribution of 57,239 euros.

Review of advanced practice nurse role in infection throughout the hematopoietic stem cell transplant journey

“…Implementation of APN led clinics provide a key opportunity for the delivery of comprehensive patient and family education around anticipated infectious complications including recommending and providing education around risk mitigation strategies, such as optimal hand, skin, dental, and respiratory hygiene practices, safety surrounding water, food, environment, animal and social contact (see Table S2). They provide an opportunity to promote a healthy lifestyle (such as exercise and nutrition), and prompt notification of possible infectious complications 27,30 . The role of psychosocial screening through APN led care is a key responsibility where anticipated psychological and/or social concerns may impact adherence to prescribed interventions.…”

“…After these issues have been identified and discussed with the wider health care team, appropriate management strategies may be implemented. This can include the early identification of depressive symptoms, allowing prompt intervention 30 . Our literature review highlights that consumers may feel more comfortable speaking with specialist nurses about these sensitive topics than other members of their care team, therefore, it is important for APNs to allow a space for these conversations to be inititated 31 .…”