Population-based screening in Wikwemikong unceded first nation.
Health Sciences North (HSN) and the Ontario Renal Network (ORN) have worked closely with Wikwemikong Unceded First Nation to pilot and deliver chronic kidney disease (CKD) and risk factor (hypertension and diabetes) screening in a community-based delivery model (based on the Manitoba Renal Program's FINISHED project). This was based on an identified gap in diabetes epidemiology in the community. Through collaboration with the community health centre and leadership, a protocol was developed to screen HgA1C, ACR, and eGFR values, and refer appropriately. Patients with elevated HgA1C (over 5.5) were referred to community diabetes services, and those at risk of CKD (based on the Kidney Failure Risk Equation) were managed by primary care with HSN nephrology support (using the Kidneywise Toolkit). Out of 378 individuals who were screened, 271 were referred to diabetes services (with 20 newly identified as diabetic), and 22 were newly identified as Stage 3 CKD requiring primary care intervention. The screening process took approximately 20 minutes at a cost of approximately $93 per person. Results will be used to review existing community health services and collaborate with provincial and federal governments to address service gaps. The screening model is being developed for expansion, with standard operation procedures and manuals being developed, and engagement underway with Aboriginal communities in the North-East Local Health Integration Network to identify future screening sites. This model serves as an example for Aboriginal community engagement and co-design, as well as screening and referral for CKD and risk factors.
Stephanie Winn, BScN, RN, Sudbury, ON, Ruth Morton, RN, Sudbury, ON, Marc Hebert, MBA, Sudbury, ON
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|Author:||Winn, Stephanie; Morton, Ruth; Hebert, Marc|
|Article Type:||Brief article|
|Date:||Apr 1, 2017|
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