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Abstract: PO0911

Automating Dialysis Machine Alarms During Sustained Low-Efficiency Dialysis (SLED)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Zasuwa, Gerard, Henry Ford Health System, Detroit, Michigan, United States
  • Yee, Jerry, Henry Ford Health System, Detroit, Michigan, United States
  • Frinak, Stanley, Henry Ford Health System, Detroit, Michigan, United States
Background

Sustained low-efficiency dialysis (SLED) with regional citrate anticoagulation (RCA) is frequently employed at our institution. RCA requires constant monitoring because a dialysis machines alarm that stops the blood pump(BP) or bypasses dialysate leads to an increased rate of citrate infusion into the patient, with consequence of ionized hypocalcemia. To enhance safety and surveillance efficiency, we developed an innovative computer/phone system that identifies SLED machine alarms and notifies clinical care staff directly via aproprietary phone network.

Methods

In 2017, we linked onboard SLED computer Wi-Fi systems to the hospital’s internal phone network (ASCOM). An alarm recorded by the SLED machine’s computer delivers an email to a dedicated email account that is subsequently transmitted to the ASCOM MailGate System. Mailgate produced and relayed text message alarms to dedicated ASCOM phones of dialysis technicians or nurses. Importantly, no additional training or changes in workflow are required for adoption of this method.

Results

This innovation has increased safety and efficiency. Response times for machine alarms improved and downtimes on dialysis were reduced, increasing dialysis dose of dialysis. To ascertain end-user satisfaction of the automated alarming system, we conducted a survey that demonstrates high-level satisfaction with the system (Table 1.)

Conclusion

Currently, no medical alert companies connect dialysis machine information to a medical alert phone system. ASCOM provides wireless messaging systems for dedicated hospital applications. Notably, ASCOM does not directly connect to dialysis machines. In addition, Email Alerts can be browsed by managers for archival retrieval, quality and safety report generation, and investigation of unanticipated events.

Staff Satisfaction Survey
Survey QuestionResponse
Frequency of SLED alarm using ASCOM alert system per shift65% respondents felt they receive between 1-3 per hour, 25% less than 1 per hour, 12.5% 4-6 per hour
Enhances Patient Safety78% agreed, while 22% strongly agreed
Dialysis Technician Response Time100% of respondents felt it improved response time
Need for ICU nurse to contact Dialysis Tech75% strongly agreed that alert system reduced ICU nursing calls, 25% had no opinion

Funding

  • Clinical Revenue Support