P149
A QUESTIONNAIRE TO DETERMINE THE RENAL DIETARY KNOWLEDGE OF
CLINICAL STAFF WORKING WITHIN THE RENAL MULTIDISCIPLINARY TEAM
MacAskill, E
Dietetic Department and Department of Renal Medicine Manchester Royal Infirmary
Problem: Malnutrition is well documented in patients with Chronic Kidney Disease, likely
exacerbated by dietary restrictions to manage phosphate, potassium and fluid levels. Dietary
treatment is an important part of managing established renal failure and healthcare professionals
(HCP’s) need to be able to support dietary modifications to maximise nutritional status. Patients
report confusion with their renal diet owing to conflicting messages being given by HCP’s.
Purpose: This study aims to identify the renal dietary knowledge of clinical staff working with
the renal multidisciplinary team (MDT) to determine whether patients receive consistent
messages about their diet. The questionnaire will determine the stronger and weaker areas of
renal diet knowledge, the results obtained will be used by the renal dietitians when devising
dietary educational programmes to ensure we maximise staff knowledge and confidence in
promoting consistent messages for patients.
Design: The questionnaire consisted of 26 questions and was split into data gathering questions
(confidence levels, previous education, length of time in renal) and dietary questions. The
dietary questions concentrated on potassium, phosphate, fluid, salt and nutritional assessment.
A pilot study was carried out on a satellite dialysis unit before rolling it out to the wider renal
team via survey monkey and paper questionnaires. Staff targeted worked in all renal areas
including medical/surgical wards, community, clinics and satellite units. Staff were given 3
weeks to complete the questionnaire with weekly prompts via email.
Findings: A total of 66 questionnaires were returned (28 via survey monkey, 38 paper copies).
Table 1 shows a summary of the scores achieved.
Section of
questionnaire
No. of
responses
Malnutrition
Phosphate
Fluid
Potassium
Salt
Total Score
66
66
66
66
66
66
Percentage of
questions answered
correctly
17-92%
0-92%
29-92%
0-100%
4-83%
15-83%
Mean score
in each
section
58%
33%
67%
42%
42%
47%
Summary of
respondents:
80% nurse/HCA
12% consultant/doctor
5% other
3% not stipulated
Length of service in
renal: 0-32 years
(mean=11 years)
Table 1
Conclusion: There was wide range of scores achieved. The mean scores for the different
dietary areas range from 33-67% accuracy with the fluid section having the highest mean score
and the phosphate section having lowest scores. The consultants/doctors achieved the highest
total mean score of 55%, nurses/HCA’s achieved 45%. The different clinical areas achieved
similar total mean scores ranging 43-55%. Staff with less experience had lower scores and
lower confidence levels. Correlation was found between length of service and total score and
between length of service and confidence level.
Relevance: The Renal Association Guidelines provide recommendations on phosphate and
potassium levels, fluid balance and the detection and management of malnutrition. The results
of this questionnaire highlight a need to promote renal dietary education for all clinical staff
within the renal MDT. This will help to improve confidence scores and ensure patients receive
consistent advice/information on their renal diet and help them achieve the targets
recommended by the renal association. The study highlights the need for a more robust
education package for all staff and provides guidance to the dietetic team on areas to
concentrate on. It has highlighted the need to focus on staff new to renal and has provided the
opportunity for staff to feedback on how they would like to receive dietary education.