Reducing incidence of and harm from acute kidney injury (AKI)
Programme Lead: Emma Vaux
Consultant Nephrologist and Programme Director of Quality Improvement, Royal Berkshire NHS Foundation Trust
Acute kidney injury resources
To improve the care of people at risk of, or with, acute kidney injury through a collaborative approach leading to better prevention, recognition and management.
The development of combined hospital and community interventions to monitor AKI across the Oxford AHSN region.
Acute kidney injury (AKI) is a common and potentially life-threatening condition that frequently occurs in acutely unwell patients in both hospital and community settings. AKI in hospitalised patients may lead to chronic end stage renal disease and is associated with high mortality rates.
Priority areas to improve the detection and management of AKI
- Compliance with the NHS England AKI Programme
- Reviewing the benefit of the sick day rules within the community
- Implementing a hydration project within care homes
- Introduction of hydration advice for patients with or at risk of a Urinary Tract Infection within all community pharmacy settings and GP surgeries
- To ascertain if the timely use of the AKI care bundle used in inpatients improves mortality rates
- To ascertain if the introduction of an electronic care bundle reduces the progression of AKI in hospital patients
- Stage 2 – to introduce a medicines review alert to ascertain if the timely review of medications (+/- stopping some nephrotoxic drugs) improves patient outcomes by reducing disease progression
- To introduce AKI care bundles throughout community settings within the Oxford AHSN region
- Innovations such as point of care creatinine testing may also have an important role in the future diagnosis of AKI.
- A hydration project in care homes in partnership with Windsor, Ascot and Maidenhead CCG
- Reducing mortality at Great Western Hospitals, Swindon, by implementing AKI care bundle within 24 hours of alert
- Oxford University Hospitals investigating whether electronic AKI care bundle reduces progress of AKI and impact on length of stay and mortality
- Reducing hospital admissions through timely intervention for patients identified with AKI in the community by introducing care bundles within GP and Out of Hours services throughout the region
Posters on the AKI projects have been presented at:
- British Renal Society Conference “A Regional Approach to Acute Kidney Injury” , April 2017
- National Patient Safety Conference “Identifying those who might benefit from electronic alerts and care bundles“, May 2017
- UK Kidney Week “Identifying those who might benefit from electronic alerts and care bundles“, June 2017
- OUH NHS Foundation Trust Quality Improvement Symposium “A regional quality improvement initiative“, July 2017