Nurses’ experiences implementing clinical practice guidelines for detecting and managing chronic kidney disease in Eswatini’s primary healthcare facilities: A qualitative study

Abstract

Background: Chronic kidney disease (CKD) is an emerging public health concern in Eswatini, with increasing prevalence among individuals with hypertension and diabetes. In primary healthcare facilities, professional nurses are essential to the early detection and management of CKD, guided by clinical practice guidelines and standardised protocols for non-communicable diseases.
Aim: This study explored the experiences of nurses in implementing clinical practice guidelines for the detection and management of CKD in primary healthcare facilities in Eswatini.
Setting: Nine selected primary healthcare facilities across Eswatini.
Methods: A qualitative, descriptive, and contextual design was used. Semi-structured interviews were conducted with 25 professional nurses, using purposive sampling. Interviews were transcribed, and thematic analysis was conducted following Gibbs’ six-step framework, with ATLAS.ti used to support data management and organisation.
Results: Three key themes and 12 sub-themes emerged from the data analysed. The three themes were: (1) nurses’ experience in implementing clinical practice guidelines, (2) training on the implementation process and the content of clinical practice guidelines, and (3) benefits of clinical practice guideline implementation.
Conclusion: Investing in nurse training in clinical practice and its implementation is essential to improving the detection and management of CKD in Eswatini’s primary healthcare facilities.
Contribution: The study provides valuable insights into the experiences of primary healthcare nurses implementing clinical practice guidelines for the early detection and management of CKD, shedding light on the challenges faced and opportunities to improve implementation in resource-constrained settings.