Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety
| Autor: | Susan R. Horton, Ellen Hopkins, Cathy S. Ross, Brian Smith, Kristine Chaisson, Gertrude Kent, Nancy Roy, Sue Bowden, Peggy Lambert, Cindy Downs, Carmen Petrin, Anita Nicholson, Emily Marshall, Janette Stender, Lynn Scott, Sheila M. Conley, Jeremiah R. Brown, Brenda Homsted |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous medicine.medical_treatment Renal function Contrast Media 030204 cardiovascular system & hematology Critical Care Nursing Nurse's Role Risk Assessment Article 03 medical and health sciences Nursing care 0302 clinical medicine Bolus (medicine) Percutaneous Coronary Intervention Patient Education as Topic New England medicine Humans 030212 general & internal medicine Intensive care medicine Qualitative Research Cardiac catheterization Aged business.industry Acute kidney injury Percutaneous coronary intervention General Medicine Acute Kidney Injury Middle Aged medicine.disease Quality Improvement Emergency medicine Female Patient Safety business Patient education |
| Zdroj: | Critical care nurse. 37(1) |
| ISSN: | 1940-8250 |
| Popis: | BACKGROUND Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. OBJECTIVE To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. METHODS Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions. RESULTS Compared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material. CONCLUSIONS Standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material. |
| Databáze: | OpenAIRE |
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