[D]r Begho Obale, Associate Specialist Doctor at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), is working with a team of staff to create a Kidney Attack Pack, which will provide vital resources for staff to improve the care of patients with Acute Kidney Injury (AKI). It will also help staff to identify those who are at risk of the condition.
The pack will include:
- A fluid balance chart
- An AKI care bundle (including an AKI admission form)
- A Lorenzo AKI Discharge Template
- AKI information card for doctors and nurses
- Patient information leaflets
- Electronic fluid balance charts and electronic records
- Two e-learning AKI resources; one for Clinical Support Workers and nurses and another for doctors
Dr Obale hopes the pack will be complete later this year and rolled out across the Trust shortly after.
AKI is a sudden deterioration in kidney function over hours to days resulting in the inability of the kidneys to perform its functions of producing adequate urine, excreting wastes, toxins and acids, eliminating excess fluids and salts. The most common causes of AKI are dehydration and sepsis.
One in five people admitted in hospitals have AKI and it is associated with over 100,000 deaths in hospitals across the country each year. Early identification of patients at risk of AKI and accurate fluid balance management is the key to treating patients with AKI more effectively.
Dr Obale said: “Acute Kidney Injury is preventable, early identification and management results in good outcomes. All ward staff working as a team guarantees better patient outcomes, reduced length of stay and reduced mortality.”
Dr Obale started the Listening into Action project last year to increase awareness of AKI amongst staff. As a result of the project, Dr Obale has trained over 300 members of staff across the Trust, on the causes of AKI and how to identify patients at risk, and other important factors, including:
- Urinalysis – how the presence of blood and protein on dipstick testing (without infection) can identify patients at risk of AKI
- How to measure and interpret urine output
- Stopping drugs with Nephrotoxic potential, which have a tendency to cause damage to the kidney especially in patients who are dehydrated, septic or have low blood pressure. Some examples of these drugs are Ibuprofen and Ramipril
Dr Obale and her team also introduced a chart to record patients’ weight and minimum expected urine output per hour so that clinical staff can monitor patients more closely. They provided patients with information on urine collection so that they are aware of importance of urine collection to their overall recovery.
Sue Smith, Executive Chief Nurse, said: “I’m delighted with the progress Dr Obale and her team of staff are making with the Kidney Attack Pack. Acute Kidney Injury is an important issue and increasing staff awareness will only result in better care for patients at risk of AKI or those already suffering from the condition.”
LiA is a key element of the improvement approach the Trust adopted in winter 2014 and is a proven model of change. Our aim is to fundamentally shift how we work and lead by putting clinicians and staff at the centre of change for the benefit of our patients, our staff and the organisation as a whole.