Acute Kidney Injury (AKI) - Using information technology to help raise AKI awareness and improve patient care & safety
Wendy Oakes, Acute Kidney Injury (AKI) specialist nurse is working with Dr Karl Bonnici, Acute Medicine Consultant at Stockport NHS Foundation Trust to raise AKI awareness and support the clinical teams to ensure patients receive high quality care and timely interventions. An AKI care bundle has been implemented to help improve the care and management of patients who have an AKI or are at risk of developing AKI.
An electronic flagging system has been developed that can be attached to the patients’ electronic record. This populates all the electronic systems (Advantis) currently used across the Trust including the Emergency Department (ED).
On ED attendance, the clinician records whether the patient has an AKI, and there is an electronic link to the AKI care bundle. Once the clinician/nurse has made an electronic record of the AKI, the plasma screens on the wards and in the ED areas display a highly visible AKI Alert Icon. This raises awareness across the multi-disciplinary team (MDT) that a patient has AKI – Red symbol for current AKI and Blue symbol for previous AKI. Stepping Hill is the first hospital in Greater Manchester using technology in this way and demonstrates the vital role information technology plays in helping to support the ‘Raising AKI Awareness’ campaign across the trust.
This automatically populates the electronic GP notification of ED attendance; it also updates the ‘alerts’ section of the electronic record which generates the printed handover document used by both nursing and medical staff in other admitting areas. The episode of AKI is automatically recorded on the patient ‘Health Care Record’ (discharge summary) provided to the GP and patient. This includes last serum creatinine and a box for free text that can be used to provide specific instructions to the GP regarding ongoing AKI monitoring/management.
The system makes a permanent record of the AKI episode so should the patient come to ED in the future, the electronic attendance record will already be populated with a message ‘Previous AKI’ with the previous episode date displayed. This means that staff will be instantly aware that the patient is at higher risk of AKI and can monitor this closely.