Effect of ICU specialist care quality control team management program in continuous renal replacement therapy: A retrospective comparative study.
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| Titel: | Effect of ICU specialist care quality control team management program in continuous renal replacement therapy: A retrospective comparative study. |
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| Autoren: | Xu X; ICU, Xianning Central Hospital, Xianning, Hubei, China., Wang M; Internal Medicine-Neurology, Xianning First People's Hospital, Xianning, Hubei, China., Wang Y; College of Nursing, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China., Pan Z; Operating Room, Xianning Central Hospital, Xianning, Hubei, China., Liu Q; Respiratory Medicine Department, PLA Strategic Support Force Characteristic Medical Center, Shenyang, Liaoning, China., Shi X; Radiology Department, Interventional Ward, Xianning Central Hospital, Xianning, Hubei, China. |
| Quelle: | Medicine [Medicine (Baltimore)] 2025 Oct 24; Vol. 104 (43), pp. e42710. |
| Publikationsart: | Comparative Study; Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins |
| MeSH-Schlagworte: | Continuous Renal Replacement Therapy*/methods , Continuous Renal Replacement Therapy*/standards , Intensive Care Units*/organization & administration , Patient Care Team*/organization & administration , Patient Care Team*/standards, Aged ; Female ; Humans ; Male ; Middle Aged ; Critical Illness/therapy ; Retrospective Studies |
| Abstract: | Competing Interests: The authors have no funding and conflicts of interest to disclose. This study aims to evaluate the effectiveness of the intensive care unit (ICU) specialist care quality control team management of patients treated with continuous renal replacement therapy (CRRT). A retrospective comparative study design was used to compare 2 groups of critically ill CRRT patients in the ICU. Subjects were 519 critically ill CRRT patients admitted to the ICU from January 2018 to December 2021. The control group (n = 265) received routine bedside care management of CRRT, and the experimental group (n = 254) received management by the CRRT specialist quality control group. Outcomes compared included unplanned down rate, unplanned down time, continuous treatment > 24 hours up to standard rate, 72 hours up to standard scheduled down rate, average daily hemodialysis cost, average use time of a single filter, unplanned extubation rate, incidence of catheter-associated bloodstream infection, nursing satisfaction, blood biochemical indexes, and coagulation indexes. The experimental group had a lower unplanned down rate(28.8% vs 42.6%), increased average unplanned down time (20.91 ± 11.21 vs 15.71 ± 7.33), higher continuous treatment > 24 hours up to standard rate (69.0% vs 55.5%), increased 72 hours up to standard scheduled down rate (16.7% vs 8.6%), decreased average daily hemodialysis cost (2947.3 ± 231.22 vs 3508.3 ± 423.22), prolonged average use time of a single filter (39.8 ± 9.47 vs 25.84 ± 7.62), lower unplanned extubation rate (1.9% vs 12.8%), and lower incidence of catheter-related bloodstream infection (0.7% vs 6.8%) compared to the control group (P < .05). The experimental group showed higher nursing satisfaction than the control group (92.9% vs 75.1%, P < .05). Blood potassium, sodium, blood urea nitrogen, and serum creatinine levels were significantly lower in the experimental group, with improved coagulation index values compared to controls (P < .05). ICU nursing quality control team management plan improve the quality of medical care, ensure patients to achieve good therapeutic effect of the goal, worthy of clinical application. (Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.) |
| References: | Tandukar S, Palevsky PM. Continuous renal replacement therapy: who, when, why, and how. Chest. 2019;155:626–38. Ronco C, Reis T. Continuous renal replacement therapy and extended indications. Semin Dial. 2021;34:550–60. Legrand M, Tolwani A. Anticoagulation strategies in continuous renal replacement therapy. Semin Dial. 2021;34:416–22. Claure-Del Granado R, Clark WR. Continuous renal replacement therapy principles. Semin Dial. 2021;34:398–405. Kovvuru K, Velez JCQ. Complications associated with continuous renal replacement therapy. Semin Dial. 2021;34:489–94. See E, Ronco C, Bellomo R. The future of continuous renal replacement therapy. Semin Dial. 2021;34:576–85. Lemarie P, Vidal SH, Gergaud S, et al. High-fidelity simulation nurse training reduces unplanned interruption of continuous renal replacement therapy sessions in critically Ill Patients: the SimHeR randomized controlled trial. Anesth Analg. 2019;129:121–8. Joannes-Boyau O, Velly L, Ichai C. Optimizing continuous renal replacement therapy in the ICU: a team strategy. Curr Opin Crit Care. 2018;24:476–82. do Nascimento JC, Sanches MB, Souza RCS. Validation of guidelines for the care of patients undergoing continuous renal replacement therapy. Nurs Crit Care. 2021;28:379–87. Juncos LA, Chandrashekar K, Karakala N, Baldwin I. Vascular access, membranes and circuit for CRRT. Semin Dial. 2021;34:406–15. Lu Z, Hong Y, Tian Y, Zhang L, Li Y. The effectiveness of a specialized nursing team intervention in the unplanned interruption of continuous renal replacement therapy. Iran J Public Health. 2022;51:544–51. Murugan R, Ostermann M, Peng Z, et al. Net ultrafiltration prescription and practice among critically Ill patients receiving renal replacement therapy: a multinational survey of critical care practitioners. Crit Care Med. 2020;48:e87–97. Hsu HT, Chiang YC, Lai YH, Lin L-Y, Hsieh H-F, Chen J-L. Effectiveness of multidisciplinary care for chronic kidney disease: a systematic review. Worldviews Evid Based Nurs. 2021;18:33–41. Prendin A, Marinelli E, Marinetto A, et al. Paediatric nursing management of renal replacement therapy: intensive care nursing or dialysis nursing? Nurs Crit Care. 2021;26:510–6. Odom B, Elliott S, Barrios CG. Promoting patient and nurse safety in acute dialysis units through advocacy and collaboration. Nephrol Nurs J. 2021;48:155–67. Baldwin I, Todd S. Therapeutic plasma exchange in the intensive care unit and with the critically ill, a focus on clinical nursing considerations. J Clin Apher. 2022;37:397–404. See EJ, Bellomo R. How I prescribe continuous renal replacement therapy. Crit Care. 2021;25:1. Ostermann M, Lumlertgul N, Mehta R. Nutritional assessment and support during continuous renal replacement therapy. Semin Dial. 2021;34:449–56. Roe NA, Wiss AL, Volgas S, Hudson JQ. Review of anticoagulation in continuous renal replacement therapy. Crit Care Nurs Q. 2022;45:144–55. Bianchi NA, Altarelli M, Eckert P, Schneider AG. Complications of regional citrate anticoagulation for continuous renal replacement therapy: an observational study. Blood Purif. 2020;49:567–75. |
| Contributed Indexing: | Keywords: ICU specialist nursing quality control team; continuous renal replacement treatment; retrospective study; safety management |
| Entry Date(s): | Date Created: 20251025 Date Completed: 20251025 Latest Revision: 20251203 |
| Update Code: | 20251203 |
| PubMed Central ID: | PMC12558308 |
| DOI: | 10.1097/MD.0000000000042710 |
| PMID: | 41137351 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: The authors have no funding and conflicts of interest to disclose.<br />This study aims to evaluate the effectiveness of the intensive care unit (ICU) specialist care quality control team management of patients treated with continuous renal replacement therapy (CRRT). A retrospective comparative study design was used to compare 2 groups of critically ill CRRT patients in the ICU. Subjects were 519 critically ill CRRT patients admitted to the ICU from January 2018 to December 2021. The control group (n = 265) received routine bedside care management of CRRT, and the experimental group (n = 254) received management by the CRRT specialist quality control group. Outcomes compared included unplanned down rate, unplanned down time, continuous treatment > 24 hours up to standard rate, 72 hours up to standard scheduled down rate, average daily hemodialysis cost, average use time of a single filter, unplanned extubation rate, incidence of catheter-associated bloodstream infection, nursing satisfaction, blood biochemical indexes, and coagulation indexes. The experimental group had a lower unplanned down rate(28.8% vs 42.6%), increased average unplanned down time (20.91 ± 11.21 vs 15.71 ± 7.33), higher continuous treatment > 24 hours up to standard rate (69.0% vs 55.5%), increased 72 hours up to standard scheduled down rate (16.7% vs 8.6%), decreased average daily hemodialysis cost (2947.3 ± 231.22 vs 3508.3 ± 423.22), prolonged average use time of a single filter (39.8 ± 9.47 vs 25.84 ± 7.62), lower unplanned extubation rate (1.9% vs 12.8%), and lower incidence of catheter-related bloodstream infection (0.7% vs 6.8%) compared to the control group (P < .05). The experimental group showed higher nursing satisfaction than the control group (92.9% vs 75.1%, P < .05). Blood potassium, sodium, blood urea nitrogen, and serum creatinine levels were significantly lower in the experimental group, with improved coagulation index values compared to controls (P < .05). ICU nursing quality control team management plan improve the quality of medical care, ensure patients to achieve good therapeutic effect of the goal, worthy of clinical application.<br /> (Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.) |
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| ISSN: | 1536-5964 |
| DOI: | 10.1097/MD.0000000000042710 |