Master of Science in Nursing (MSN)
Acute kidney failure (AKI) is common among patients in the intensive care unit (ICU) and can have a mortality rate of up to 70%. Continuous renal replacement therapy (CRRT) provides constant dialysis treatment and is the recommended treatment for hemodynamically unstable AKI patients. Delay in CRRT delivery and interruptions of therapy are associated with negative outcomes such as fluid overload, electrolyte imbalance, acid-base imbalance and death. To reduce CRRT downtime, there has been a trend for the critical care nurse to be autonomous with the set-up, management and\ trouble-shooting of treatment instead of a collaboration between the critical care nurse and dialysis nurse. The purpose of this study was to investigate the difference in CRRT therapy downtime with critical care nurse management compared to collaborative management performed by the critical care nurse and dialysis nurse. This research was guided by Benner’s Novice to Expert Model as it best represents the trajectory for nurses attaining the clinical competence to master total management of CRRT. A retrospective chart review was conducted with a total of 43 downtime incidences managed autonomously by the critical care nurse and a total of 48 CRRT downtime incidences managed by a collaboration between the critical care nurse and dialysis nurse. Results demonstrated that the mean CRRT downtime managed autonomously by the critical care nurse, 7,728.8 seconds was significantly less than the CRRT downtime managed by a collaboration between the critical care nurse and dialysis nurse, 13,915 seconds (p =0.01). Further research is indicated to determine the best nursing management of CRRT to reduce treatment downtime.
Gardner, Lisa, "Does Nurse Management Effect Continuous Renal Replacement Downtime?" (2019). Master's Theses, Dissertations, Graduate Research and Major Papers Overview. 300.
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