Does acute kidney injury alerting improve patient outcomes?

BMC Nephrology

Research

Joseph Gavin¹  Peter Hewins²  Mark Garrick²  Simon Ball³  Tanya Pankhurst⁴  Jamie Coleman⁵  Jolene Atia⁶  Felicity Evison⁶  Suzy Gallier⁷ 

[1] Lister Hospital, Stevenage, UK;University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK;HDRUK Better Care Science Priority and Health Data Research UK Midlands, University of Birmingham, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK;Queen Elizabeth Hospital Birmingham, Mindelsohn Way, B15 2TH, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK;School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Institute of Translational Medicine, Edgbaston, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK;University Hospitals Birmingham NHS Foundation Trust, Institute of Translational Medicine, Edgbaston, Birmingham, UK;PIONEER: HDR-UK Health Data Research Hub for Acute Care, University of Birmingham, Birmingham, UK;

关键词: Acute Kidney Injury;    Patient outcomes;    Referral;    Electronic Health records;    Electronic Patient Records;   

DOI  :  10.1186/s12882-022-03031-y

 received in 2022-04-01, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundElectronic alerts (e-alerts) for Acute Kidney Injury (AKI) have been implemented into a variety of different Electronic Health Records (EHR) systems worldwide in order to improve recognition and encourage early appropriate management of AKI. We were interested in the impact on patient safety, specialist referral and clinical management.MethodsAll patients admitted to our institution with AKI were included in the study. We studied AKI progression, dialysis dependency, length of hospital stay, emergency readmission, ICU readmission, and death, before and after the introduction of electronic alerts. The impact on prescription of high risk drugs, fluid administration, and referral to renal services was also analysed.ResultsAfter the introduction of the e-alert, progression to higher AKI stage, emergency readmission to hospital and death during admission were significantly reduced. More prescriptions were stopped for drugs that adversely affect renal function in AKI and there was a significant increase in the ICU admissions and in the number of patients having dialysis, especially in earlier stages. Longer term mortality, renal referrals, and fluid alteration did not change significantly after the AKI e-alert introduction.ConclusionsAKI e-alerts can improve clinical outcomes in hospitalised patients.

【 授权许可】

CC BY   
© Crown 2023

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