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Authors

  1. Cordoza, Makayla PhD, RN, CCRN-K
  2. Rachinski, Kristen MSN, RN, CCRN-CMC
  3. Nathan, Kristin MN, RN, CCRN
  4. Crain, Elisa B. MSN, BA, RN
  5. Braxmeyer, Diane DNP, AGACNP-BC
  6. Gore, Sarah MSN, RN, CCRN
  7. Dubuc, Stephanie D. BSN, RN, CCRN
  8. Wright, Joel MSN, BA, RN

Abstract

Background: Continuous renal replacement therapy (CRRT) is a lifesaving intervention for critically ill patients. Delays in initiation, or an inability to resume CRRT following a temporary suspension in therapy (CRRT restart), can result in suboptimal CRRT delivery.

 

Local Problem: Intensive care units across the health care system were experiencing significant delays in CRRT initiation and restarts.

 

Approach: A multimodal quality improvement initiative was implemented across 7 adult intensive care units, which allowed unit-based staff nurses to initiate and restart CRRT, a task that had previously been delegated to non-unit-based dialysis nurses.

 

Outcomes: A 75% reduction in CRRT initiation delays and a 90% reduction in CRRT restart delays were observed in the 12 months following the initiative. There were no adverse events or increased disposable CRRT circuit usage following the initiative.

 

Conclusions: Implementation of CRRT initiation and restarts by unit-based nurses were achievable and resulted in substantial improvements in timeliness of CRRT delivery.