Impact of an Electronic Alert in Combination with a Care Bundle on the Outcomes of Acute Kidney Injury.
Ana Carolina Nakamura TomeRodrigo José RamalhoKarise Fernandes Dos SantosBianca PonteHelga AgostinhoMauricio Nassau MachadoMarcelo Barreto LopesMario Abbud-FilhoEmerson Quintino de LimaPublished in: Diagnostics (Basel, Switzerland) (2022)
Early diagnosis is essential for the appropriate management of acute kidney injury (AKI). We evaluated the impact of an electronic AKI alert together with a care bundle on the progression and mortality of AKI. This was a single-center prospective study that included AKI patients aged ≥ 18 years, whereas those in palliative care, nephrology, and transplantation departments were excluded. An AKI alert was issued in electronic medical records and a care bundle was suggested. A series of classes were administered to the multidisciplinary teams by nephrologists, and a clinical pharmacist audited prescriptions. Patients were categorized into pre-alert and post-alert groups. The baseline characteristics were comparable between the pre-alert (n = 1613) and post-alert (n = 1561) groups. The 30-day mortality rate was 33.6% in the entire cohort and was lower in the post-alert group (30.5% vs. 36.7%; p < 0.001). Age, pulmonary disease, malignancy, and ICU admission were associated with an increase in 30-day mortality. The electronic AKI alert together with a care bundle and a multidisciplinary education program was associated with a reduction in 30-day mortality in patients with AKI.
Keyphrases
- acute kidney injury
- palliative care
- clinical decision support
- cardiac surgery
- quality improvement
- healthcare
- end stage renal disease
- cardiovascular events
- chronic kidney disease
- ejection fraction
- newly diagnosed
- advanced cancer
- peritoneal dialysis
- risk factors
- prognostic factors
- cardiovascular disease
- stem cells
- intensive care unit
- metabolic syndrome
- affordable care act
- skeletal muscle
- mesenchymal stem cells
- chronic pain
- bone marrow
- health insurance
- cell therapy
- glycemic control