Team’s work to reduce risk of harm from kidney infection commended nationally

Posted on in Hospitals, Services

A team’s role in reducing the risk of patient harm from acute kidney injury (AKI) has been ‘highly commended’ at The National Patient Safety Awards.

AKI, which means a sudden reduction in kidney function, usually occurs when a patient is unwell with another medical problem, such as infection, and often means their condition is worsened resulting in a longer hospital stay.

Because AKI often begins without symptoms, it can develop unnoticed by patients and staff and national studies suggest this limited awareness often means detection and treatment is delayed.

Across South Tees Hospitals NHS Foundation Trust, a small team – led by Consultant Nephrologist Dr Jon Murray – have been working hard to raise awareness and encourage all staff to look out for the condition in order to understand how to combat AKI promptly on their own wards.

A total of 54 dedicated AKI workshops were run by Dr Murray’s team over six months with staff from all roles and specialties receiving training to use an AKI alerting system and new guidelines they had developed. Areas deemed to be of higher risk also received additional support from Sister Claire Allinson, a specialist renal nurse at the Trust.

Results from an independent clinical informatics company (CRAB Clinical Informatics Limited) who monitored patient outcomes before, during and after the team’s concerted efforts, found the organisation’s AKI rates fell dramatically during their programme, particularly on high risk surgical wards where they fell by over a third (36%). Prior to this, rates were similar to those found in other UK hospitals.

“AKI rates continue to run at these reduced rates, some nine months after their AKI programme finished,” said Dr Mark Ratnarajah, Managing Director (UK) of CRAB Clinical Informatics.

“This may reflect a sustained change in AKI culture following the AKI Programme at South Tees.”

Now the team has been highly commended in the ‘Patient Safety in Surgical Care’ category in the HSJ’s National Patient Safety Awards which recognise and reward outstanding practice in the NHS.

Dr Murray said: “AKI is considered a patient safety thermometer – because its presence usually indicates a patient’s condition is deteriorating. Timely AKI detection helps to promptly identify deteriorating patients. A common misconception is that AKI is a complex ‘kidney problem’ needing specialist doctors when often simple steps by ward teams can reduce poor outcomes associated with this condition.

“We recognised a widespread approach was needed to address this and so we involved clinicians, managers and patients to develop our programme.  Not only did this collective approach work at the time, it may also underlie an apparent sustained impact upon AKI culture across the Trust.”

The team, which includes Advanced Nurse Practitioner Clare Allinson, Lead for Service Improvement and Innovation Gill Husband and Deputy Director (Clinical Effectiveness) Tony Roberts, continue to review our organisation’s data collected by CRAB Clinical Informatics.

The Trust’s AKI guidelines and training resources, which include a video describing how AKI affected one of their patients, have now been rolled out to seven other Trusts across the North East, as part of an Academic Health and Science Network Project that Dr Murray is leading to unify AKI care across the whole region.