• Acute Kidney Injury: Continuous Quality Improvement for Systems Change

      Bassett, Robin (University of Alaska Anchorage, 2016-12-01)
      Acute Kidney Injury (AKI) is reduced kidney function over hours to days which can be reversible but can lead to renal failure and death. AKI is diagnosed using serum creatinine and urine output but these factors are not sensitive or specific, and no biomarker has been found for more accurate diagnosis. International guidelines for AKI diagnosis and treatment were released in 2012 by the Kidney Disease: Improving Global Outcomes (KDIGO) group. Many providers are not aware of AKI and guidelines for treatment have not been implemented in practice. The purpose of this continuous quality improvement (CQI) project was to improve healthcare team member knowledge of AKI Guidelines and to develop electronic health records (EHR) tools to improve AKI recognition and diagnosis. EHR tools were developed for implementation during a two-month CQI practice initiative. An Excel spreadsheet for AKI diagnosis and EHR renal protection protocols were created and tested. Updates were made to the tools to allow ease of use based on interprofessional feedback. A trifold AKI educational pamphlet was developed following implementation to fill gaps in knowledge. The interprofessional critical care team survey reported the tools were helpful in facilitating AKI recognition and management according to published guidelines. More work is needed to find sustainable and significant improvements in AKI recognition, diagnosis, and treatment. AKI guidelines should be disseminated to non- nephrology professionals after revision to allow for increased diagnosis and management of this critical and common problem.