Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Michelle L. Koopman


Doctor of Nursing Practice


The presenting quality improvement project was based on primary care providers’ practice for identifying, tracking and trending early stages of chronic kidney disease in diabetic patients. The PICO question derives from literature reviews specifically addressing variations in practice in the primary care setting in patients with high-risk morbidities such as diabetes to track kidney function. By providing education to new family practice residents in the Mercy health Residency program at Mercy health South, it was determined that new primary care providers would have an opportunity to identify kidney disease in the early stages. Education provided with Kidney Disease Initiative Global Outcomes early-stage detection guidelines with recommended labs and follow-up practices was implemented in the EPIC charting system through alerts and smart sets. The hypothesis in the quality project was as follows; providing education to the residents at Mercy health South about the Kidney Disease Initiative Global Outcomes as the gold standard for identification, diagnosis, and further care through lab analysis, more patients would have earlier diagnosis and management. Methods used to educate were through the Mercy health online learning center, including a pre-and post-knowledge survey. The data results showed initially there was acknowledgment to the patients needing for lab analysis and follow-up but as the weeks of data collection continued, a plateau of acknowledgment showed the residents were using the override option more than initially. The trends in the smart set use had little change from the beginning data set collections to the final. The implication of the outcome is unclear from education to lab recognition and use is unclear.

Available for download on Monday, September 11, 2023