Gaps in Dialysis Staff Knowledge of the Kidney Transplantation Process

Abstract

Introduction: For patients receiving dialysis, education from dialysis staff is vital to make informed treatment decisions. Effective education practices are predicated on dialysis staff being well-informed about the kidney transplant process. We assessed dialysis staff knowledge of the transplant process and described staff and facility characteristics associated with knowledge. Methods: A 17-item adaptation of the Knowledge Assessment of Renal Transplantation (KART) instrument was used to assess dialysis staff knowledge of the kidney transplantation process. Surveys were emailed to 2000 dialysis centers across 4 US regions (August 2021-August 2022). Associations between staff and facility characteristics and correct response scores were assessed using analysis of variance and by ordinal regression for score quartiles. Results: Of the 630 responses assessed (among 33.5% response rate), respondents were mostly female (91.4%), social workers (81.1%), and worked at chain-owned facilities (86.2%). The average correct response score was 11.8 (69%). Correct responses for individual items ranged from 9.4% to 95.9%. In the adjusted regressions, the odds of scoring highly was reduced for non-social workers (vs. social workers; adjusted odds ratio [aOR]: 0.39; 95% confidence interval [CI]: 0.25-0.63), time working in role (vs. 8-10 years; < 1 year aOR: 0.11 [95% CI: 0.04-0.25], 1-3 years aOR: 0.21 [95% CI: 0.10-0.43], 4-7 years aOR: 0.38 [95% CI: 0.19-0.78], > 10 years aOR: 0.42 [95% CI: 0.21-0.85]), and region (vs. Southeast; New York aOR: 0.52 [95% CI: 0.29-0.94]). Conclusion: The adapted-KART assessment revealed significant gaps and variation in dialysis staff knowledge of transplantation processes. Interventions to improve staff training and reduce gaps in staff knowledge are needed to ensure appropriate patient education regarding kidney transplantation for patients receiving dialysis.