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Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety
Journal article   Peer reviewed

Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety

Peggy Lambert, Kristine Chaisson, Susan Horton, Carmen Petrin, Emily Marshall, Sue Bowden, Lynn Scott, Sheila Conley, Janette Stender, Gertrude Kent, …
Critical care nurse, Vol.37(1), pp.13-26
02/01/2017
DOI: 10.4037/ccn2017178
PMCID: PMC5557383
PMID: 28148611

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Abstract

BACKGROUND Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. OBJECTIVE To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. METHODS Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions. RESULTS Compared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m(2). Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material. CONCLUSIONS Standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.
Nursing Critical Care Medicine General & Internal Medicine Life Sciences & Biomedicine Science & Technology

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