title: Chronic kidney disease in an Aboriginal population: A nurse practitioner-led approach to management.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is a significant health problem impacting Australia's Aboriginal and Torres Strait Islander population. After age adjustment, the prevalence of kidney disease is 3.7 times higher in Aboriginal people and 7.3 times higher for end-stage kidney disease compared with the wider population. Yet at an Aboriginal Community Controlled Health Service (ACCHS) with a significant patient population, fewer than expected numbers of Aboriginal patients were identified with CKD.
  
  
  METHODS
  The ACCHS engaged a nurse practitioner to lead a systematic approach to the identification and treatment of CKD.
  
  
  METHODS
  This nurse practitioner-led approach to CKD was developed and implemented at a rural NSW ACCHS, with the support of a partnership formed between the nurse practitioner, the ACCHS, a nephrologist from a referral hospital and a statewide NGO.
  
  
  METHODS
  The primary measure for improvement has been to identify and stage patients with CKD and establish management plans as appropriate.
  
  
  METHODS
  This nurse-led project was established to: (i) identify patients with CKD; (ii) provide access for CKD patients to appropriate services; (iii) commence pharmacological and non-pharmacological strategies that enable remission or regression of CKD; and (iv) educate practice GPs and other staff members on CKD clinical guidelines and best practice.
  
  
  RESULTS
  The CKD project has improved access to essential health care for vulnerable and at-risk populations, with 187 patients to date having been identified with kidney disease and staged for its severity.
  
  
  CONCLUSIONS
  The need for strong multi-disciplinary teamwork has been demonstrated with good communication strategies implemented.
authors.affiliation: NSW Rural Doctors Network, Mascot, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett
authors.affiliation: Durri Aboriginal Corporation Medical Service, Kempsey, New South Wales, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Salem
authors.affiliation: Durri Aboriginal Corporation Medical Service, Kempsey, New South Wales, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Wilson
authors.affiliation: NSW Rural Doctors Network, Mascot, New South Wales, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: O'Neill
authors.affiliation: Durri Aboriginal Corporation Medical Service, Kempsey, New South Wales, Australia.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Davis
authors.affiliation: NSW Rural Doctors Network, Mascot, New South Wales, Australia.
authors.forename: Sharif
authors.initials: S
authors.lastname: Bagnulo
mesh_terms: D001315:Australia; D005260:Female; D006297:Health Services Accessibility; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000451:nursing* / Q000628:therapy; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Aboriginal health; access; chronic disease; health service models; nurse practitioners