Abstract: PO0214
Provider Acceptance of Electronic AKI Alerts in a Cardiac Surgery ICU
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Sakhuja, Ankit, West Virginia University, Morgantown, West Virginia, United States
- Mohamed, Nada, West Virginia University, Morgantown, West Virginia, United States
- Goodiwn, Donnie B., West Virginia University, Morgantown, West Virginia, United States
- Neely, Rebecca L., West Virginia University, Morgantown, West Virginia, United States
- Cook, Chris, West Virginia University, Morgantown, West Virginia, United States
- Mullett, Charles J., West Virginia University, Morgantown, West Virginia, United States
- Smith, Gordon S., West Virginia University, Morgantown, West Virginia, United States
- Kellum, John A., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Background
Electronic acute kidney injury (AKI) alerts can improve the rates of detection of AKI, though their effect on improving patient outcomes has been variable. Their focused utilization in cardiac surgery patients, a population at a high risk for both AKI and its complications, is likely to lead to more consistent improvement in outcomes. We implemented AKI alerts in the cardiac surgery ICU of a tertiary care, high volume cardiac surgery center starting July 2020. As electronic alerts can be disruptive to the workflow and lead to alert fatigue, we surveyed health care providers in our cardiac surgery intensive care unit (ICU) regarding their acceptance of these electronic AKI alerts.
Methods
Our AKI alerts used a previously validated logic to trigger an alert when serum creatinine increase by 0.3mg/dL or more within last 52 hours. They were implemented as passive alerts in the EPIC electronic medical record. Alerts were situated in the EPIC storyboard and provided information in the format “Possible AKI Stage X”, with the option to get more information by hovering over the alert. The alerts were set to disappear if no further increase in creatinine by at least 0.3mg/dL was noted in next 52 hours. We emailed a validated survey regarding alert usefulness to providers 6 months into the alerts implementation to assess their acceptance.
Results
Out of 19 ICU providers (7 intensivists and 12 advanced practice providers) all but one responded to the survey. 7/18 (38.8%) providers reported that they recognized AKI earlier due to the alert. 16/18 (88.9%) shared that they re-dosed or discontinued medications earlier due to the AKI alert. Majority of participants also reported earlier management of volume status (72.2%), avoidance of iv contrast use (72.2%) and point of care ultrasound use (77.8%) in response to the alert. 15/18 (83.3%) reported satisfaction with the way AKI alerts are displayed and overall satisfaction with the AKI alerts. 16/18 (88.9%) providers reported satisfaction with the duration the alert is displayed for.
Conclusion
Among providers taking care of patients at high risk for AKI, the electronic AKI alert well received. A follow up survey is planned to assess the changes in longitudinal perception of the AKI alert.
Funding
- Other NIH Support