Care Bundles for Acute Kidney Injury: Do They Work?

Selby, Nicholas M.; Kolhe, Nitin

doi:10.1159/000447758

Cited by 24 publications

(20 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies show that implementation of laboratory-based AKI detection systems coupled with clinical decision support ensure that patients with AKI are recognised, and that they receive treatment to mitigate the increased CKD and mortality risk. 21…”

Section: Discussionmentioning

confidence: 99%

“…Automatic reporting of estimated glomerular filtration rate has provided a sensitive, readily available measure of loss of kidney function, but is not valid under non steady‐state conditions such as AKI. Studies show that implementation of laboratory‐based AKI detection systems coupled with clinical decision support ensure that patients with AKI are recognised, and that they receive treatment to mitigate the increased CKD and mortality risk …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Under‐detection of acute kidney injury in hospitalised patients: a retrospective, multi‐site, longitudinal study

Campbell

Kotwal

et al. 2020

Internal Medicine Journal

View full text Add to dashboard Cite

Background Acute kidney injury (AKI) is a rapid deterioration of renal function, often caused by a variety of co‐existing morbidities complicating its recognition and treatment, leading to short‐ and long‐term adverse clinical outcomes. There are limited data on the incidence of AKI in Australia using the Kidney Disease Improving Global Outcomes creatinine‐based consensus definition. Aim To determine the incidence and estimate the extent of under‐reporting of AKI in four hospitals in the South‐Eastern Sydney/Illawarra regions of New South Wales, Australia. Method A laboratory algorithm based on the Kidney Disease Improving Global Outcomes creatinine‐based definition for AKI was applied retrospectively to laboratory data for adult patients admitted to the study hospitals between 2009 and 2013 to identify those with AKI. The results were compared with the incidence of AKI based on diagnostic codes for AKI reported for the same period. Results AKI was detected in 12.4% of all hospitalisations (46 101/370 969) and 16.4% of patients (31 448/192 133) across the 5‐year study period using the laboratory algorithm. Of these, 72.1% were AKI Stage 1 (33 246/46101). AKI was coded in only 15.9% of hospitalisations with AKI Stage 1 (5294/33 246), 38.5% of hospitalisations with Stage 2 (2381/6185), and 46.8% with Stage 3 (3120/6670). Yearly incidence of laboratory‐identified AKI trended downward between 2009 and 2013, while annual incidence determined by coding trended upward. Conclusion Although coding trends suggested a continuous increase in clinician awareness of AKI across the study period, AKI in hospitalised patients remained significantly under‐reported.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Under‐detection of acute kidney injury in hospitalised patients: a retrospective, multi‐site, longitudinal study

Campbell

Kotwal

et al. 2020

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…[ 30 ] Recently, AKI care bundles have shown the ability to improve outcomes. [ 31 – 33 ] Our study results, with follow-up of up to 1 year, reveal that the patients with AKI stages 2 and 3 have a significantly inferior survival rate compared with the patients without AKI or with AKI stage 1. The further application of AKI bundles in patients with SJS/TEN who are diagnosed as having AKI warrants more investigation.…”

Section: Discussionmentioning

confidence: 74%

The influence of acute kidney injury on the outcome of Stevens–Johnson syndrome and toxic epidermal necrolysis: The prognostic value of KDIGO staging

Lee

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

BackgroundStevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are severe drug-induced cutaneous adverse reactions with high mortality. Acute kidney injury (AKI) was a common complication in an SJS/TEN group and noted as an independent risk factor for mortality in patients with SJS/TEN. To determine whether AKI staging can predict the outcome of patients with SJS/TEN, we compared the discriminative power of an AKI KDIGO staging system with that of SCROTEN, APACHE II, APACHE III, and SOFA.Materials and methodsWe retrospectively analyzed the data of 75 patients who were diagnosed with SJS, TEN, or SJS/TEN overlap syndrome at a tertiary care university hospital between January 1, 2011 and December 31, 2014. The baseline characteristics, biochemical analysis data, medication use, and outcomes of the patients were assessed, and the discriminative ability for predicting mortality was determined for each prognostic model.ResultsOf the 75 patients, 23 (30.7%) had AKI, of whom 13 (56.5%) died during the index admission. Of the prognostic risk models analyzed, the KDIGO staging system showed similar discriminative ability in predicting in-hospital mortality as did the other models. In addition, combining KDIGO with other scoring systems yielded significantly more accurate risk prediction for in-hospital mortality compared with the other individual scores alone, as measured by net reclassification index. The patients with KDIGO stages 2 and 3 exhibited a significantly lower 1-year survival rate than did those with KDIGO stages 0 and 1.ConclusionAKI KDIGO staging has good discriminative ability and is easy to utilize for predicting mortality.

show abstract

“…Further, when implemented collectively, a care bundle significantly improves the reliability of care and patient outcomes beyond that expected when each treatment is implemented individually (Bagshaw, 2015). Care bundles have been applied more widely in recent years, not only in clinical interventions but also in assessment procedures, and have led to improvements in patient outcomes (Pronovost et al, 2006;McCarron, 2011;Coyer et al, 2015;Selbya & Kolhe, 2016). Care bundles may be effective in preventing and managing a range of conditions such as sepsis (Damiani et al, 2015), central line-associated bloodstream infections (Ista et al, 2016), and chronic obstructive pulmonary disease (Ospina et al, 2017).…”

Section: Care Bundlementioning

confidence: 99%

A nonsurgical and nonpharmacological care bundle for preventing upper urinary tract damage in patients with spinal cord injury and neurogenic bladder

Fang

Lin

Liu

et al. 2019

Int J of Nursing Practice

View full text Add to dashboard Cite

Aim To establish a care bundle in spinal cord injury patients with neurogenic bladder to avoid upper urinary tract damage and to provide guidance for health care staff in use of nonsurgical and nonpharmacological adjunctive strategies to improve patients' clinical outcomes. Background Prevention of upper urinary tract damage is critical in the management of spinal cord injury patients with a neurogenic bladder, but there are no authoritative guidelines or high‐quality randomized controlled trials. Design The study was conducted on the basis of Fulbrook and Mooney's seven‐step method for care bundle development. Data Sources The databases PubMed, Embase, Science Citation Index, the Cumulative Index to Nursing and Allied Health Literature, the National Guideline Clearinghouse, the Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, and China Dissertation Database were searched from the date of each database's inception to April 2017. Review methods We evaluated the literature according to the Joanna Briggs Institute evidence pre‐ranking and grade recommendation system (2014 version). The results were examined using a self‐designed data extraction. Results A three‐element cluster including clean intermittent catheterization, bladder function training, and transcutaneous low‐frequency pulsed electrical stimulation was formed. Conclusion The development of this bundle can provide a scientific basis for effective prevention of neurogenic upper urinary tract damage in clinical practice.

show abstract

Care Bundles for Acute Kidney Injury: Do They Work?

Cited by 24 publications

References 15 publications

Under‐detection of acute kidney injury in hospitalised patients: a retrospective, multi‐site, longitudinal study

Under‐detection of acute kidney injury in hospitalised patients: a retrospective, multi‐site, longitudinal study

The influence of acute kidney injury on the outcome of Stevens–Johnson syndrome and toxic epidermal necrolysis: The prognostic value of KDIGO staging

A nonsurgical and nonpharmacological care bundle for preventing upper urinary tract damage in patients with spinal cord injury and neurogenic bladder

Contact Info

Product

Resources

About