Utilizing Frailty Assessment to Impact Nursing Care for Patients with End Stage Kidney Disease: A Quality Improvement Project.

Frailty is highly prevalent in patients with end stage kidney disease (ESKD) and predictive of morbidity. Nurses lack frailty education and face practical challenges to assessment, which prevent effective interventions to address frailty. A quality improvement project sought to determine if frailty education and utilization of a renal frailty index tool impacts telephonic case management nursing care of patients by improving knowledge, perception, identification, and assessment of frailty, thereby prompting nursing interventions. Positive impacts were seen across all outcomes influencing outreach and resource utilization by nurses. Limitations included a small sample size, time burden, and manual processes. Findings suggest the importance of embedding frailty care into daily practice, automation of frailty scoring, and expansion into advanced practice to improve quality of care and reduce cost of care.