Date of Award

Spring 5-2022

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Carolyn Coleman

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Lisa Morgan

Committee Member 2 School

Leadership and Advanced Nursing Practice


According to Blumrosen et al. (2020), the dialysis population cost expenditure is greater than “seven percent of the Medicare budget at nearly $40 billion a year” even though this population is “less than one percent of the Medicare population” (p. 1436). Additionally, the renal disease population is growing in the United States and internationally which contributes to rising healthcare costs around the globe (Levin, 2018).

The purpose of this Doctor of Nursing Practice (DNP) project was to identify the factors or reasons hemodialysis patients miss treatments or only stay for partial treatment. Hemodialysis patients are required to have treatments three times weekly. However, hemodialysis patients have a high incidence of missed or shortened treatments. The patient population who misses treatment are at risk of poor outcomes such as fluid overload, hospitalizations, and mortality.

Depression may be the reason for missed treatments. The retrospective quantitative review was conducted on each patient if they missed one or more treatments in a four-month window (Al Salmi et al., 2018). The practitioner-researcher collected data in the retrospective review to ascertain depression scores, previous treatments, or previous mental health treatment. The DNP researcher was searching to find the answer to improve this patient population outcomes.