Featured Research

from universities, journals, and other organizations

Reducing kidney injury using quality improvement method

Date:
July 29, 2014
Source:
The Geisel School of Medicine at Dartmouth
Summary:
Using quality improvement measures in hospitals, researchers have found a way to reduce kidney injury in patients undergoing a procedure with contrast dye. Currently, 7-15 percent of these patients who undergo a coronary stent procedure with contrast-dye end up with kidney injury, which can result in death or rapid decline in kidney function leading to temporary or permanent dialysis, says a new study.

Using quality improvement measures in eight of the 10 hospitals in the Northern New England Cardiovascular Disease Study Group, researchers have found a way to reduce kidney injury in patients undergoing a procedure with contrast dye.

Currently, 7-15 percent of these patients who undergo a coronary stent procedure with contrast-dye end up with kidney injury, which can result in death or rapid decline in kidney function leading to temporary or permanent dialysis, says a study published in the July issue of Circulation Cardiovascular Quality Outcomes journal. Previous to this study, based on quality improvement methods in the hospitals, little has been done to adopt evidence-based interventions though it has been a patient safety objective of the National Quality Forum.

While researchers looked specifically at patients in the cardiology catheterization lab, they believe the methods they developed over a six-year period to prevent kidney injury are generalizable to all of medicine and contrast procedures.

"We believe that using a team-based approach and having teams at different medical centers in northern New England learn from one-another to provide the best care possible for their patients," said Jeremiah Brown of The Dartmouth Institute for Health Policy & Clinical Practice.

Brown and his colleagues found that using a quality improvement design and team coaching, they could reduce kidney injury by 20 percent among all patients and by 30 percent among patients with pre-existing chronic kidney disease.

"Some of the most innovative ideas came from these teams and identified simple solutions to protect patients from kidney injury resulting from the contrast dye exposure," Brown said. "These included getting patients to self-hydrate with water before the procedure (8 glasses of water before and after the procedure), allow patients to drink fluids up to two hours before the procedure (whereas before they were "NPO" for up to 12 hours and came to the hospital dehydrated), training the doctors to use less contrast in the procedure (which is good for the patient and saves the hospital money), and creating stops in the system to delay a procedure if that patient had not received enough oral or intravenous fluids before the case (rather, they would delay the case until the patient received adequate fluids)."

Using a simple team-based approach, Brown and colleagues from 10 medical centers in northern New England prevented kidney injury in 1 out of every 5 patients undergoing a cardiac catheterization procedure.

"Our regional success was really about hospital teams talking and innovating with one another. Instead of competing with one another in similar health care markets, they shared their data, protocols, and ideas resulting in simple, homegrown, easy to do solutions that improved patient safety across the region," Brown said.


Story Source:

The above story is based on materials provided by The Geisel School of Medicine at Dartmouth. Note: Materials may be edited for content and length.


Journal Reference:

  1. J. R. Brown, R. J. Solomon, M. J. Sarnak, P. A. McCullough, M. E. Splaine, L. Davies, C. S. Ross, H. L. Dauerman, J. L. Stender, S. M. Conley, J. F. Robb, K. Chaisson, R. Boss, P. Lambert, D. J. Goldberg, D. Lucier, F. A. Fedele, M. A. Kellett, S. Horton, W. J. Phillips, C. Downs, A. Wiseman, T. A. MacKenzie, D. J. Malenka. Reducing Contrast-Induced Acute Kidney Injury Using a Regional Multicenter Quality Improvement Intervention. Circulation: Cardiovascular Quality and Outcomes, 2014; DOI: 10.1161/%u200BCIRCOUTCOMES.114.000903

Cite This Page:

The Geisel School of Medicine at Dartmouth. "Reducing kidney injury using quality improvement method." ScienceDaily. ScienceDaily, 29 July 2014. <www.sciencedaily.com/releases/2014/07/140729164902.htm>.
The Geisel School of Medicine at Dartmouth. (2014, July 29). Reducing kidney injury using quality improvement method. ScienceDaily. Retrieved September 20, 2014 from www.sciencedaily.com/releases/2014/07/140729164902.htm
The Geisel School of Medicine at Dartmouth. "Reducing kidney injury using quality improvement method." ScienceDaily. www.sciencedaily.com/releases/2014/07/140729164902.htm (accessed September 20, 2014).

Share This



More Health & Medicine News

Saturday, September 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins