Management of Acute Kidney Injury in Trauma and Orthopaedic Patients
Background
Why this project was needed
Acute kidney injury (AKI) is a common and potentially life-threatening complication in trauma and orthopaedic inpatients, particularly in the elderly population undergoing emergency surgery. NICE guidelines require prompt recognition of AKI warning stage alerts and clinical review within defined timeframes. Concerns were raised following review of adverse incidents involving AKI in the department, prompting a formal audit of AKI recognition and management in T&O patients at both GSTT sites.
Aims
What the project set out to achieve
To audit management of patients flagged as AKI stage 2 or 3 and those requiring naloxone reversal in the Trauma and Orthopaedic department at GSTT, measuring compliance with NICE and local guidelines.
Objectives
Specific measurable steps
- Identify T&O patients admitted between September 2023 and March 2024 who were flagged as AKI stage 2 or 3 or who received naloxone.
- Assess timeliness of clinical review following AKI alert generation.
- Review pre-operative renal function checks for elective surgical patients.
- Evaluate referral rates to nephrology and clinical review at 3-month post-discharge follow-up.
Discussion
Community experience and questions
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