Abstract
Purpose: The purpose of this project is to implement an evidence-based screening tool for early initiation of continuous renal replacement therapy (CRRT) in patients with sepsis.|Background: Patients diagnosed with sepsis and acute kidney injury are at risk for lengthened ICU stay and increased mortality rate. It was identified that CRRT was not being utilized as often as it should be and instead was used as a last effort to save patients with an acute kidney injury related to sepsis. With the initiation of a KDIGO guideline-base checklist it allows for earlier recognition of acute kidney injuries with hopes of decreasing length of stay and mortality rates for septic patients.|Sample/Setting: Project took place in a 12-bed intensive care unit at a 250-bed Midwest hospital. This study focused on patients that were admitted with sepsis or screened positive for sepsis as an inpatient.|Methods: Patients admitted to the intensive care unit were screened for sepsis. If a sepsis screen was positive, urine output and creatinine level were assessed based on the KDIGO guideline-based checklist. If criteria were met, a nephrology consult was placed. The nephrologist would decide if CRRT was indicated, or other measures should be attempted first. Data collected through this time span was compared to the previous year (December 2019- January 2020). Sepsis data included length of stay and mortality rates.|Results: Data preliminary results are showing that nephrology was consulted sooner after the check list was initiated. The length of stay may have been decreased while mortality rates have been consistent throughout all data. Prior to initiation of the KDIGO guideline-based checklist nephrology may not have been consulted at any point during ICU stay.|Conclusion: Having a KDIGO guideline- based checklist allows for nephrology to be consulted at the first sign of an acute kidney injury in patients with sepsis. Nephrology is able to intervene and initiate treatment sooner whether that be continious renal replacement therapy or a less invasive form of treatment. Early nephrology consults and possible initiation of CRRT provides the opportunity to improve outcomes in a patient with sepsis and acute kidney injuries.