What is it about?
Nurses play a pivotal role in the recognition, escalation and management of acute illness. Acute kidney injury (AKI) is an illness known as the 'silent killer' as there are few outward signs that a patient has anything wrong with their kidneys. However, there are certain signs and symptoms that a nurse can look out for to recognise AKI but this requires a level of knowledge. A questionnaire was therefore devised to 'test' this knowledge in a small group (n=30) of nurses. However, it is understood that questionnaires can mask true knowledge as answers can be guessed. Therefore, alongside the knowledge questions, participants were asked to rate their confidence in whether they had answered each question correctly, This highlighted those areas where nurses may have answered correctly but were not confident in their answer. Such mismatches suggests that when in clinical practice, the participants may not escalate concerns appropriately due to their perceived lack of confidence in their observations and patients may not receive appropriate care.
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Why is it important?
Acute Kidney Injury (AKI) is present in all areas of nursing. In 2009, an NCEPOD report emphasised how a lack of clinical knowledge within the UK hospital sector was leading to avoidable deaths from AKI. Covid increased rates of AKI in patients and once again, highlighted the difficulties in its recognition and the need for general nurses' knowledge on this acute illness if it is to be recognised in a timely manner . This piece of work highlights those areas where general nurses are not confident in their knowledge levels and so allows for targeted education.
Perspectives
Using confidence as an adjunct to knowledge has truly changed the way I teach and how I mentor nurses in the workplace. Whilst knowledge questionnaires can be helpful to provide a snapshot of knowledge, coupling that knowledge with their confidence level can offer an insight into how that knowledge may be translated into practice. In areas of poor knowledge and/or confidence, I find it important to recognise team members as go-to's for support, guidance and signposting. Nursing is not about knowing everything but recognising when you need help, particularly in the identification of a deteriorating patient.
Claire Osmer
Read the Original
This page is a summary of: Nurses’ knowledge and confidence in acute kidney injury: a feasibility study, Journal of Kidney Care, November 2022, Mark Allen Group,
DOI: 10.12968/jokc.2022.7.6.269.
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