The Effect of Implementing Acute Kidney Injury Care Bundle on Clinical Outcomes of Critically Ill Patients

Document Type : Research articles

Authors

1 Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria Universit

2 Critical Care Medicine, Faculty of medicine, Alexandria University

3 Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Abstract

Background: Healthcare quality and cost are major driving forces in healthcare delivery system. 
Evidence- based bundle of care, is a concept usually involves three to five structured interventions based 
on scientific evidence based, which when carried out consistently improve patient outcomes. AKI is one 
of the major complications of critical illness and its management, prevention and management can be 
achieved through AKI care bundle which aims to manage and prevent newly developed AKI in critically 
ill patients. Objective: To determine the effect of implementing acute kidney injury care bundle on 
clinical outcomes of critically ill patients. Settings: The study was carried out in the General ICUs 
namely; Casualty unit (unit I), General ICU (unit II, III) at Alexandria Main University Hospital, Egypt.
Subjects: A convenient sample of 70 newly admitted adult patients aged 18-<60 years were included in
this study. Patients who had preexisting AKI, chronic kidney disease and/or on renal replacement therapy 
were excluded from the study. The sample was equally assigned into two equal groups: group I, the 
control group (35 patients) and group II, the study group (35 patients). Tools: Two tools were used. Tool 
one: “ICU acquired AKI risk assessment”. Tool two: ''Clinical outcomes assessment tool''. Results: The 
study showed that neither patients in the study group nor the control group had AKI on 1st day (baseline), 
however during 2nd to 7th day 0.0%, 14.3%, 8.6%, 0.0%, 0.0% and 0.0% of patients in the study group 
developed AKI compared to 14.3%, 42.9%, 45.7%, 20.0%, 28.6% and 22.9% of patients in the control 
group. Conclusion: Implementation of AKI care bundle interventions significantly decreased the
occurrence of ICU acquired AKI. Recommendations: Critical care nurses should conduct a baseline 
assessment to identify high risk patients for development of ICU acquired AKI

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