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Reliable and valid tools are needed to assist nurses to prospectively identify high-risk patients with kidney failure. Early identification of high-risk patients permits targeting of nursing interventions and resources to improve quality and cost outcomes. A 16-item risk assessment tool, Risk for Outcomes Adverse to Dialysis (ROAD), was developed based on a comprehensive review of the literature on risk factors associated with adverse outcomes with kidney failure. Reliability and validity of the ROAD was tested on a random sample of 253 participants in the Anemia Management Demonstration Project. High risk scores on the ROAD were significantly associated with hospitalization 1 to 6 months following risk assessment and inversely correlated with physical and mental components of quality of life. The results indicate that the ROAD provides a useful tool to identify patients on hemodialysis at risk of poor outcomes. 

Gerri Lamb, PhD, RN, FAAN, is Associate Dean and Associate Professor, University of Arizona, College of Nursing, Member, Case Manager Solutions, LLC, Tucson, AZ.

Kevin E. Kip, PhD, is Assistant Professor, University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA.

Donna Mapes, DNSc, RN, is Principal, Donna Mapes and Associates, and Adjunct Professor, University of California, San Francisco, San Francisco, CA; she is a member of ANNA’s Northern California Chapter.

Sally Burrows-Hudson, MS, RN, CNN, is Senior Associate Director of Nephrology Medical Affairs, Amgen, Inc., and Adjunct Professor, University of California, San Francisco, San Francisco, CA. She is a Past President of ANNA and a member of the Northern California Chapter.

Toni Cesta, PhD, RN, FAAN, is Director of Case Management, St. Vincents Hospital, New York, NY, and Member, Case Manager Solutions, LLC, Tucson, AZ.

Donna Zazworsky, MS, RN, FAAN, is Director, Community Nursing and Outreach, St. Elizabeth of Hungary Clinic, Tucson, AZ, and Member, Case Manager Solutions, LLC, Tucson, AZ.

Note: Funding for the research was provided by Amgen, Inc., Thousand Oaks, CA. Figure 1 in this article is reprinted with the permission of Amgen, Inc.

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