Background: Intradialytic hypotension (IDH) is one of the most common complications among patients receiving maintenance hemodialysis, affecting approximately 20%–30% of treatments. IDH is linked to adverse outcomes, including treatment interruptions, inadequate dialysis delivery, cardiovascular complications, reduced quality of life, and increased morbidity. Despite evidence-based recommendations, variability in nurses’ knowledge, confidence, and management practices may contribute to inconsistent recognition and treatment of IDH in outpatient dialysis settings.
Purpose: This quality improvement project aims to evaluate the effectiveness of an evidence-based educational program in improving registered nurses’ knowledge, confidence, awareness of clinic policy, and application of evidence-based practices for managing intradialytic hypotension in an outpatient hemodialysis clinic.
Methods: A quasi-experimental pre- and post-intervention design will be used. Registered nurses at the participating outpatient dialysis clinic will complete a pre-intervention survey assessing baseline knowledge, confidence, policy awareness, and current clinical practices related to IDH management. Participants will then complete an evidence-based educational program focused on the recognition, prevention, management, and documentation of IDH. Eight weeks after the intervention, nurses will complete a post-intervention survey evaluating changes in knowledge, confidence, awareness of clinic protocols, use of evidence-based interventions, and perceptions of the educational program. Descriptive and inferential statistics will be used to analyze quantitative data, and open-ended responses will undergo thematic analysis.
Expected Outcomes: The educational intervention is expected to improve nurses’ knowledge of IDH, increase confidence in recognizing and managing hypotensive episodes, enhance awareness of organizational policies, promote the use of evidence-based clinical practices, and strengthen the application of standardized management strategies. Findings may inform future educational initiatives and quality improvement efforts aimed at standardizing nursing practice in outpatient dialysis settings.
Implications for Practice: Improving nurses’ competency in recognizing and managing IDH can strengthen evidence-based nursing practice, enhance patient safety, and reduce practice variation. Although this project focuses on nursing outcomes, its findings may lay the groundwork for future quality improvement projects that evaluate the impact of educational interventions on patient-centered outcomes, including the incidence of IDH, dialysis adequacy, treatment interruptions, hospitalization rates, and patient satisfaction.
