Quality measures for acute kidney injury and continuous renal replacement therapy

被引:30
|
作者
Rewa, Oleksa [1 ]
Mottes, Theresa [2 ]
Bagshaw, Sean M. [1 ]
机构
[1] Univ Alberta, Fac Med & Dent, Div Crit Care Med, Edmonton, AB, Canada
[2] Cincinnati Childrens Hosp Med Ctr, Ctr Acute Care Nephrol, Div Nephrol, Cincinnati, OH 45229 USA
关键词
acute kidney injury; continuous renal replacement therapy; quality; safety; CRITICALLY-ILL PATIENTS; RANDOMIZED CONTROLLED-TRIAL; CITRATE ANTICOAGULATION; HEPARIN ANTICOAGULATION; REGIONAL CITRATE; ADVERSE EVENTS; MANAGEMENT; OUTCOMES; AKI; CLEARANCE;
D O I
10.1097/MCC.0000000000000262
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose of review Quality and safety are important priorities in the care of critically ill patients. For patients with acute kidney injury (AKI) or for those receiving continuous renal replacement therapy (CRRT), measures and outcomes associated with quality of care have been suboptimally developed and evaluated. The review is timely as it summarizes current quality practices in AKI and CRRT, and presents ongoing and future developments. Recent findings The review begins with the history of quality and safety in healthcare. We then discuss the current quality of care offered in AKI and CRRT. Quality measure development methodology, such as plan-do-study-act and the focus-analyze-describe-execute models and lean thinking are then presented and discussed. Finally, recent evidence for quality in AKI and CRRT care, including proposed quality measures, are discussed. Summary Few studies have examined the quality of care provided to patients with AKI and CRRT. Evidence suggests opportunities to improve the quality of care received by patients at risk of or who have developed AKI. Priorities for improving quality of care exist across several important themes including risk identification, diagnosis, monitoring, investigation, and strategies for management. Similarly, evidence-informed quality measures of CRRT care have not been rigorously evaluated. These are important knowledge-to-care gaps that require further investigation.
引用
收藏
页码:490 / 499
页数:10
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