Original Article

The Effectiveness of a Specialized Nursing Team Intervention in the Unplanned Interruption of Continuous Renal Replacement Therapy

Abstract

Abstract

Background: To explore the application of specialist nursing teams in patients undergoing unplanned interruptions in continuous renal replacement therapy.

Methods: Sixty-six patients admitted to the intensive care unit of Jiangsu Province Hospital, China for continuous renal replacement therapy (CRRT) and experienced unplanned interruptions from Aug 2020 to Mar 2021 were enrolled as study subjects. Twenty four patients with conventional care were taken as the control group, and 42 patients in the specialized nursing team were taken as the experimental group. The age, type of disease, and degree of illness of the two groups were statistically processed and the differences were not significant (P>0.05) and were comparable. The control group received routine CRRT care after CRRT rescue, and the experimental group received CRRT care model from a specialized nursing team.

Results: Patients in the group with specialized nursing care had 49 instances of CRRT unplanned interruptions, and the routine care group had 79 instances of CRRT unplanned interruptions. The number of unplanned interruptions in the experimental group was less than that of the control group, and the difference was statistically significant (P<0.001). The incidence of complications in the experimental group were lower than that of the control group (P<0.05). The satisfaction and quality of life of nurses in the specialist nursing group were clearly lower than those of the control group, and the difference was statistically significant (P<0.05).

Conclusion: Specialist nursing teams could reduce the occurrence of unplanned interruptions in CRRT patients in intensive care and allow patients to receive continuity of care.

1. Tolwani A (2012). Continuous renal-replacement Therapy for acute Kidney in-jury. N Engl J Med, 367(26):2505-2514.
2. Rewa O, Villeneuve PM, Lachance P, et al (2017). Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review. Intensive Care Med, 43(6):750-763.
3. Roeder VR, Atkins HN, Ryan MA, Harms HJ (2013). Putting the C back in to con-tinuous renal replacement therapy. Nephrol Nurs J, 40(6):509-15.
4. Rewa O, Villeneuve PM, Eurich DT, et al (2015). Quality in dicators in continuous renal replacement therapy (CRRT) care in critically ill patients: protocol review. Syst Rev, 4:102.
5. Finkelman A (2013). The clinical nurse spe-cialist: Leadership in quality improvement. Clin Nurs Spec, 27(1):31-35.
6. Fang XH, Mei BG (2016). Analysis of the causes of unscheduled off-boarding of continuous renal replacement therapy and nursing countermeasures. Chongqing Medi-cine, 45(27):3881-3883.
7. Lai YH, Luo SF, Au HM (2020). Effect of standardized nursing procedures on the chance of unscheduled CRRT down. General Practice Nursing, 18(06):728-731.
8. Fei S, Jin J, Wang H, Zeng F, Xu J, Chen J (2015). Study on factors associated with unplanned down time of continuous re-nal replacement therapy. Chinese Journal of Nursing, 2015, 50(1).
9. Baldwin I, Fealy N (2009). Nursing for renal replacement therapies in the Intensive Care Unit: historical, educational, and protocol review. Blood Purif, 27(2):174-18.
10. Chen, Xiang-Mei (2010). Standard operating procedures for blood purification [M]. Beijing: People's Military Medical Publish-ing House, 43-49.
11. Benfield CB, Brummond P, Lucarotti A, et al (2015). Applying lean principles to con-tinuous renal replacement therapy pro-cesses. Am J Health Syst Pharm, 72(3):218-23.
12. Sanchez-Izquierdo-Riera JA, Molano-Alvarez E, Saez-de la Fuente I,et al (2016). Safety management of a clinical process using failure mode and effect analysis: continu-ous renal replacement therapies in inten-sive care unit patients. ASAIO J, 62(1):74-9.
13. Windt K (2016). Development of online learning modules as an adjunct to skills fairs and lectures to maintain nurses' competency and comfort level when car-ing for pediatric patients requiring con-tinuous renal replacement therapy ( CRRT). Nephrol Nurs J, 43(1):39-46.
14. Patel S, Topping A, Ye X, et al (2018). Asso-ciation between Heights of dialysis pa-tients and outcomes: results from a ret- rospective cohort study of the interna-tional MONitoring Dialy- sis Outcomes (MONDO) database initiative. Blood Purif, 45(1-3):245-253.
Files
IssueVol 51 No 3 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i3.8930
Keywords
Continuous renal replacement rate Intensive care unit (ICU) Unplanned interruption rate

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Lu Z, Hong Y, Tian Y, Zhang L, Li Y. The Effectiveness of a Specialized Nursing Team Intervention in the Unplanned Interruption of Continuous Renal Replacement Therapy. Iran J Public Health. 2022;51(3):544-551.