Time to STOP Acute Kidney Injury (AKI) - 08/12/17
Résumé |
Background |
Acute kidney injury (AKI) is a serious condition that is often unrecognized leading to delays in treatment. AKI is an independent risk factor for mortality, intensive care admission and length of stay in hospital. In the UK a National Patient Safety Alert was issued around the recognition and response to AKI as a preventable cause of death and an estimated annual cost of £ 500 million per year to the NHS. A UK BAPN audit in 2012 of 6 centers showed > 60% of AKI cases were unrecognized. Studies in adults on electronic alerts (e-alerts) for AKI have shown an improvement in recognition but not subsequent response with fluid resuscitation and timely antibiotics.
Method |
A Quality Improvement Project was devised in a large tertiary children's hospital in the UK to improve response and recognition to AKI. The project was based on the children's oncology unit, which is an area of high incidence of AKI with high-risk patients, often in high-risk scenarios. The project utilised Plan Do Study Act (PDSA) cycles and the improvement model. The stages are: initiation of e-alerts on the blood results server, raising awareness of e-alerts, education package on AKI response and recognition which is now informing the development of a AKI care bundle.
Results |
The overall incidence of AKI is low, mean 8–10 per week since the interventions there has been an increase in recognition and a decrease in the number of AKI stage 1 that progressed. There has been no increase in the number of blood tests being requested (balancing measure). Interestingly false positive alerts have been seen in children on hyperhydration for risk of tumour lysis syndrome.
Conclusion |
A multidisciplinary approach can achieve improvements in recognition & response to AKI.
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Vol 24 - N° 12
P. 1334 - décembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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