AUDIT

Management of AKI Amongst Trauma & Orthopaedic Patients

Guy's and St Thomas' NHS Foundation Trust 2024 Orthopaedics
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Guidelines Used
NICE NG191
Background
NICE NG191 and Trust AKI guidelines mandate early detection and structured management of hospital-acquired AKI, but T&O inpatients at GSTT show inconsistent risk assessment, fluid management and care-bundle delivery
Aims
o improve adherence to Trust and NICE AKI guidelines for identification and management of AKI in T&O inpatients at GSTT during the audit cycle.
Objectives
Identify cohort: Capture all T&O inpatients flagged with AKI stage 2 or 3 from 1 September 2023 to 31 March 2024. Process measure: Audit completion of AKI-risk assessments on admission and documentation of fluid‐management plans. Bundle compliance: Review implementation of AKI care-bundle elements (e.g. medication review, input/output monitoring). Education intervention: Deliver an AKI-management workshop to T&O staff by month 3. Re-audit: Repeat the AKI audit in month 6, aiming for ≥80% compliance with guideline-recommended assessments and bundle delivery .
Keywords
Acute kidney injury AKI management NICE NG191 Orthopaedic inpatients Hospital-acquired AKI AKI care bundle Clinical audit

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