Date

Summer 2024

Document Type

Scholarly Project

Department

College of Nursing

First Advisor

Kathleen Bradshaw

Abstract

Problem Statement: Adults with Type 2 diabetes mellitus and chronic kidney disease experience a higher risk for progression to end-stage kidney disease, which negatively impacts health, increases medical costs, and decreases quality of life. Purpose: Determine if an audit and feedback intervention in a local nephrology clinic can increase provider adherence to a clinical practice guideline that supports the prescription of sodium glucose cotransporter-2 (SGLT-2) inhibitors. Methods: A pretest-posttest design was used to determine if an audit and feedback tool delivered to providers at three-week intervals would increase prescription of SGLT-2 inhibitors in adults with Type 2 diabetes and chronic kidney disease over three months. A clinical decision guide was provided to participants at the onset of the intervention with one-on-one structured interviews accompanying the audit and feedback cycles. Inclusion Criteria: English-speaking physicians and advanced practice providers were recruited from a local nephrology outpatient clinic in the southeastern United States. Analysis: To evaluate the significance of the intervention, a chi-square test was used to evaluate the change in prescribing of SGLT-2 inhibitors compared to the three months prior to the intervention. Logistic regression assisted with examining the relationship between the intervention and proportion of new SGLT-2 inhibitor prescriptions. Implications for Practice: In this setting, statistical analysis indicated that the intervention significantly increased prescription of SGLT-2 inhibitors in adults with Type 2 diabetes and chronic kidney disease. Additional implementation on a larger scale is needed to validate findings and further investigate barriers to prescription reported by participants.

Rights

© 2024, Megan Elaine Lanpher

Available for download on Thursday, July 31, 2025

Included in

Nursing Commons

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