A Participatory Action Research Study to inform the Development and Implementation of Combined Type 2 Diabetes and Chronic Kidney Disease Care Provided in the Context of Advanced Practice Nursing

The rise in the incidence of type 2 diabetes with chronic kidney disease across the age spectrum has been highlighted as a major public health concern and is correlated with increased economic burden, patient suffering and mortality. Preventative care and early chronic kidney disease management strategies informed by best practice recommendations are associated with improved clinical outcomes, patient survival and reduced economic burden. However, opportunities to implement preventative and early management strategies are missed when the care for type 2 diabetes and chronic kidney disease are provided separately. Patients report an uncoordinated impersonal approach when type 2 diabetes and chronic kidney disease care is provided separately. Furthermore, facilitating a combined care strategy enhances care coordination, communication and quality. As current healthcare delivery strategies are failing to implement best practice early management strategies or achieve best practice targets, an alternative approach is required to meet the needs of care providers and patients. One such strategy was the development and implementation of combined type 2 diabetes and chronic kidney disease care, informed by best practice early management recommendations provided in the context of advanced practice nursing. Contemporary literary discourse indicates care provided in the context of advanced practice nursing is safe and effective, albeit there is no national and limited international evidence pertaining to the direct care contribution for patients with type 2 diabetes and chronic kidney disease. The main aim of this national and international unique study was to utilise co-created knowledge between health care professionals and patients to inform development and implementation of combined care provided in the context of advanced practice nursing. The outcomes of this study will inform development and implementation of future services for patients with type 2 diabetes and chronic kidney disease led by advanced nurse practitioners. A Participatory Action Research approach was utilised, as this nonlinear iterative process facilitates flexibility and responsiveness to challenges presented within the current healthcare environment.