SP268REDUCTION IN ACUTE KIDNEY INJURY (AKI) MORTALITY DATA WITH THE DEVELOPMENT OF A NOVEL AKI MANAGEMENT BUNDLE

Abstract

Introduction and Aims: Acute Kidney Injury (AKI) has a mortality rate of 30%, greater than common conditions such as myocardial infarction (8%) and stroke (9%). It is estimated that 15% of all inpatients at University Hospital Aintree (UHA), Liverpool, UK, suffer an AKI making it a condition of considerable importance in everyday practice. Through clinical audit, it was found that mortality rate of AKI in UHA was 33% on wards other than renal ward (9%). The aim is to reduce AKI mortality by 30% and length of stay by 20% over a 12 month period from Oct 2013. Methods: Using plan, do, study act (PDSA) methodology, we developed and tested an automated e-alert diagnostics system, an AKI treatment bundle and a patient information leaflet. Our Primary drivers were Early and accurate identification of AKI, Effective intervention and monitoring, Staff and Patient engagement. Initially, trialled at ward level, the project was scaled up to admission areas (AED, MAU) becoming part of routine management for all admitted patients. Results: Fall in mortality rates from a baseline of 24% to 18.5 %, representing an overall reduction in mortality of 23%. Length of stay fell by 11% equating in a 2.0 day reduction in length of stay Conclusions: Since the introduction of the AKI bundle in Oct 2013 we have achieved not only a significant reduction in patient mortality and length of stay but in addition a more structured and stream lined way of approaching the patients with AKI in our hospital. With the bundle being rolled out to primary care and the rest of our inpatient wards, we anticipate a further reduction in mortality and if this is achieved we advocate the bundle being adopted first regionally and then nationally. (Figure Presented).