Appl Clin Inform 2023; 14(01): 119-127
DOI: 10.1055/a-2000-7499
Research Article

Acceptance of Acute Kidney Injury Alert by Providers in Cardiac Surgery Intensive Care Unit

Connor Nevin
1   School of Medicine, West Virginia University, Morgantown, West Virginia, United States
,
Khaled Shawwa
2   Section of Nephrology, Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States
,
Jami Pincavitch
3   Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States
,
Rebecca L. Neely
4   West Virginia University, Morgantown, West Virginia, United States
,
Donnie Goodwin
5   Section of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, United States
,
Paul McCarthy
5   Section of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, United States
,
Nada Mohamed
6   Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, United States
,
Charles Mullett
7   Department of Pediatrics, West Virginia University, Morgantown, West Virginia, United States
,
Gordon S. Smith
8   Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, United States
,
John A. Kellum
9   Department of Critical Care Medicine, Medicine, Bioengineering, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Ankit Sakhuja
5   Section of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, United States
10   Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
› Author Affiliations
Funding The project described was supported by the National Institute of General Medical Services (U.S. Department of Health and Human Services, National Institutes of Health, National Institute of General Medical Sciences, grant no.: 5U54GM104942-03) and National Institute of Diabetes and Digestive and Kidney Diseases (U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, grant no.: 1K08DK131286-01A1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Abstract

Background Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Its management relies on early diagnosis, and therefore, electronic alerts have been used to alert clinicians for development of AKI. Electronic alerts are, however, associated with high rates of alert fatigue.

Objectives We designed this study to assess the acceptance of user-centered electronic AKI alert by clinicians.

Methods We developed a user-centered electronic AKI alert that alerted clinicians of development of AKI in a persistent yet noninterruptive fashion. As the goal of the alert was to alert toward new or worsening AKI, it disappeared 48 hours after being activated. We assessed the acceptance of the alert using surveys at 6 and 12 months after the alert went live.

Results At 6 months after their implementation, 38.9% providers reported that they would not have recognized AKI as early as they did without this alert. This number increased to 66.7% by 12 months of survey. Most providers also shared that they re-dosed or discontinued medications earlier, provided earlier management of volume status, avoided intravenous contrast use, and evaluated patients by using point-of-care ultrasounds more due to the alert. Overall, 83.3% respondents reported satisfaction with the electronic AKI alerts at 6 months and 94.4% at 12 months.

Conclusion This study showed high rates of acceptance of a user-centered electronic AKI alert over time by clinicians taking care of patients with AKI.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects, and was reviewed by WVU Institutional Review Board. Participants were informed of the contents prior to study participation and voluntarily consented to participate.




Publication History

Received: 30 June 2022

Accepted: 11 December 2022

Accepted Manuscript online:
19 December 2022

Article published online:
08 February 2023

© 2023. Thieme. All rights reserved.

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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