Abstract: SA-PO432
Single Center Experience: Conversion From Conventional Continuous Renal Replacement Therapy to Tablo Adaptive Dialysis
Session Information
- Hemodialysis and Frequent Dialysis: Clearance, Technology, Infection
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Greenleaf Nichols, Tara E., Covenant HealthCare, Saginaw, Michigan, United States
- Rowe, Sandy, Covenant HealthCare, Saginaw, Michigan, United States
- Dutton, Debra M., Covenant HealthCare, Saginaw, Michigan, United States
- Yurcso, Toni, Covenant HealthCare, Saginaw, Michigan, United States
- Ramaiyah, Senthil P., Covenant HealthCare, Saginaw, Michigan, United States
Background
Since the advent of the COVID-19 pandemic in March 2020, the ability to provide high quality, cost efficient care in the ICU has been challenged by nursing shortages, increased acuity, patient volumes and higher incidence of AKI requiring dialysis. CRRT typically requires 1:1 nursing support and specialized devices. Here we describe Covenant Healthcare, a 372 acute bed hospital that converted from conventional CRRT model (“Non-Tablo”) to an adaptive dialysis model with the Tablo® Hemodialysis System (“Tablo”).
Methods
A retrospective chart review of extended therapy treatments over six months after transition to Tablo. All Tablo treatments performed in the ICU that met the previous hospital criteria for CRRT were included. Nurse to patient ratio during dialysis was 1:1 and 1:2 when not on therapy. Demographics, COVID status, treatment duration and time off therapy, defined as hours within each 24-hr period where the patient was not on dialysis was recorded. Treatment success was defined as achieving at least 90% of prescribed treatment time.
Results
A total of 228 treatments were completed in 60 ICU patients with 60% COVID positive. Mean age was 62 yrs (range, 29-88). Total treatment success was 96% with 4% ending early due to alarms. Figure 1 shows total treatment by time; 0-6 hrs, >6-12, >12-24 hrs with success rates. Total time off therapy compared to a Non-Tablo continuous model was 2299 hrs equating to approximately 1.2 FTE ($100k) in labor productivity.
Conclusion
At Covenant Healthcare, conversion to Tablo adaptive therapy model successfully delivered treatments up to 24 hrs to critically ill patients who would otherwise be on CRRT. Adaptive therapy improved nurse staffing efficiency while reducing cost and patient time off dialysis. Application of this model allows a more individualized approach to ICU patient care without increasing the burden on the ICU or acute hospitals.