Acceptance of Acute Kidney Injury Alert by Providers in Cardiac Surgery Intensive Care Unit.

Autor:	Nevin C; School of Medicine, West Virginia University, Morgantown, West Virginia, United States., Shawwa K; Section of Nephrology, Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States., Pincavitch J; Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States., Neely RL; West Virginia University, Morgantown, West Virginia, United States., Goodwin D; Section of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, United States., McCarthy P; Section of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, United States., Mohamed N; Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States., Mullett C; Department of Pediatrics, West Virginia University, Morgantown, West Virginia, United States., Smith GS; Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, United States., Kellum JA; Department of Critical Care Medicine, Medicine, Bioengineering, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States., Sakhuja A; Section of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, United States.; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
Jazyk:	angličtina
Zdroj:	Applied clinical informatics [Appl Clin Inform] 2023 Jan; Vol. 14 (1), pp. 119-127. Date of Electronic Publication: 2022 Dec 19.
DOI:	10.1055/a-2000-7499
Abstrakt:	Background: Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Its management relies on early diagnosis, and therefore, electronic alerts have been used to alert clinicians for development of AKI. Electronic alerts are, however, associated with high rates of alert fatigue. Objectives: We designed this study to assess the acceptance of user-centered electronic AKI alert by clinicians. Methods: We developed a user-centered electronic AKI alert that alerted clinicians of development of AKI in a persistent yet noninterruptive fashion. As the goal of the alert was to alert toward new or worsening AKI, it disappeared 48 hours after being activated. We assessed the acceptance of the alert using surveys at 6 and 12 months after the alert went live. Results: At 6 months after their implementation, 38.9% providers reported that they would not have recognized AKI as early as they did without this alert. This number increased to 66.7% by 12 months of survey. Most providers also shared that they re-dosed or discontinued medications earlier, provided earlier management of volume status, avoided intravenous contrast use, and evaluated patients by using point-of-care ultrasounds more due to the alert. Overall, 83.3% respondents reported satisfaction with the electronic AKI alerts at 6 months and 94.4% at 12 months. Conclusion: This study showed high rates of acceptance of a user-centered electronic AKI alert over time by clinicians taking care of patients with AKI. Competing Interests: A.S. has been supported by the WVCTSI Research Scholar Award through the National Institute of General Medical Services (U.S. Department of Health and Human Services, National Institutes of Health, National Institute of General Medical Sciences, grant no.: 5U54GM104942-03) and is currently supported by the National Institute of Diabetes and Digestive and Kidney Diseases (U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, grant no.: 1K08DK131286-01A1). (Thieme. All rights reserved.)
Databáze:	MEDLINE
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