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Abstract: SA-PO024

CME Effectively Improves the Clinical Performance of Nephrologists, Nurses, and Nurse Practitioners Related to Comprehensive, Chronic Hyperkalemia Management

Session Information

  • Educational Research
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 800 Educational Research


  • Larkin, Amy, Medscape Education , Nicholasville, Kentucky, United States
  • Anderson, David R., Medscape LLC, New York, New York, United States
  • Boutsalis, George, Medscape, New York, New York, United States

Chronic hyperkalemia requires comprehensive management. We sought to determine if online continuing medical education (CME) could improve the clinical performance of nephrologists and nurses/nurse practitioners related to chronic management of hyperkalemia.


The CME activity was a 15-minute interactive case study with patient-physician vignettes featuring a patient with uncontrolled T2D, HF, and CKD for whom chronic hyperkalemia management was required. A repeated pairs pre-/post-assessment study design was used and chi-square test (P <.05 is considered significant) assessed educational effect for each activity. Cramer's V was used to calculate the effect size (0.06-0.15 is a noticeable effect, 0.16-0.26 considerable, and >0.26 extensive). The activity launched September 21, 2018 and data were collected through November 30, 2018.


In total, 88 nephrologists and 1,504 nurses were included in the study.

Upon patient presenting with increasing serum creatinine levels, proteinuria, and mild hyperkalemia, 52% (P <.001; V=.473) of nephrologists and 41% of nurses (P <.0001; V=.364) improved at recommending a low-potassium diet in addition to dose reduction of a potassium-lowering drug
One month later, upon recognition of chronic potassium elevation, 36% of nephrologists (P <.001; V=.357) and 29% of nurses (P <.001; V=.214) improved at adding a potassium binding agent
Three months post potassium binder initiation, patient returns with normal serum potassium levels, 42% of nephrologists (P <.001; V=.388) and 36% of nurses (P <.001; V=.370) improved at managing continued elevated blood pressure
32% of nephrologists and 44% of nurses reported increased confidence in adding a potassium binding agent in a patients taking multiple drugs that can induce hyperkalemia

Continued educational gaps:
36% of nephrologists and 53% of nurses failed to effectively manage the patients’ blood pressure
23% of nephrologists and 39% of nurses failed to initiate a potassium binding agent when indicated


This study demonstrates the success of online, CME-accredited, interactive case study with patient-physician vignettes on significantly improving clinical performance of nephrologists and nurses related to chronic management of hyperkalemia. Continued gaps were identified for future educational targets.


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