Date of Award
Fall 12-8-2025
Document Type
Dissertation
Publication Status
Version of Record
Submission Date
December 2025
College Granting Degree
Christine E. Lynn College of Nursing
Degree Name
Doctor of Nursing Practice (DNP)
Thesis/Dissertation Advisor [Chair]
Katherine Chadwell
Abstract
This quality improvement (QI) project aimed to enhance adherence to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines for placement of tunneled dialysis catheters (TDCs) in intensive care unit (ICU) patients. The project addressed inconsistent application of best practices related to TDC placement, improved documentation, improved communication using TigerConnect, a reduction in inappropriate catheter placements, and maintenance of a zero hospital-acquired tunneled dialysis catheter-related bloodstream infection (CRBSI) rate. Notably, some patients continued to be admitted with pre-existing community-acquired tunneled catheter-related infections, underscoring the effectiveness of the hospital’s internal infection prevention strategies while highlighting the need for enhanced collaboration with outpatient dialysis providers to reduce community-acquired infections. The intervention incorporated structured educational sessions and standardized assessment protocols. Participants included nephrologists, intensivists, interventional radiologists, advanced practice providers, and infectious disease doctors and infection prevention specialists. Data were collected through pre- and post-intervention surveys, chart audits, infection surveillance, and training completion rates. Descriptive statistics were used to evaluate adherence to the guidelines, safety outcomes, and the effectiveness of training. The findings demonstrated improved documentation, improved communication using TigerConnect, reduced inappropriate catheter placements, and continued hospital-acquired infection-free status since September 2024. The project highlighted the importance of interprofessional collaboration, vascular access planning, and system-level integration of best practices. Guided by Marilyn Ray’s Theory of Bureaucratic Caring, the initiative demonstrated how DNP-prepared nurses could lead organizational change by aligning policy-driven protocols with patient-centered care.
Recommended Citation
Echagaray, Gabriela, "IMPROVING PATIENT OUTCOMES THROUGH IMPLEMENTATION OF THE KDOQI GUIDELINES FOR TUNNELED DIALYSIS CATHETER PLACEMENT" (2025). Electronic Theses and Dissertations. 158.
https://digitalcommons.fau.edu/etd_general/158