Journal List > J Korean Acad Nurs Adm > v.20(5) > 1051773

TOOLS
Choi and Yi: Effects of the Schematized Alarm-managing Manual for Continuous Renal Replacement Therapy on the Alarm Resolution Rate and Nursing Competence of Nurses in Intensive Care Units
Original Article

Journal of Korean Academy of Nursing Administration 2014; 20(5): 535-544.

Published online: 31 December 2014

DOI: https://doi.org/10.11111/jkana.2014.20.5.535

Effects of the Schematized Alarm-managing Manual for Continuous Renal Replacement Therapy on the Alarm Resolution Rate and Nursing Competence of Nurses in Intensive Care Units

Aeng Ja Choi1, Young Hee Yi2

1Department of Nursing, Samsung Medical Center, Korea.

2Department of Clinical Nursing Science, Samsung Medical Center · School of Medicine, Sungkyunkwan University, Korea.

Corresponding author: Yi, Young Hee. Department of Clinical Nursing Science, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Ilwon-ro, Seoul 135-710, Korea. Tel: +82-2-2148-9930, Fax: +82-2-2148-9949, iyyh@skku.edu

Received 23 July 2014       Revised 11 September 2014       Accepted 14 October 2014

Copyright © 2014 Korean Academy of Nursing Administration

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was done to develop a schematized alarm-managing manual for continuous renal replacement therapy (CRRT) and to investigate its effects in maintaining continuity in the patients' treatment and promptly resolving alarms when CRRT is being carried out.

Methods

Sixtynurses from two medical intensive care units (ICUs) (one experimental and one control) at one hospital were asked to answer a questionnaire including their CRRT nursing competency and satisfaction with the manual. Data on alarm resolution rate were collected by analyzing existing data, such as the details of each alarm and the number of resolutions around the clock in the CRRT device.

Results

The alarm resolution rate and some of CRRT nursing competency scores in the experimental group were higher than those in the control group. The experimental group was also satisfied with the manual.

Conclusion

The study confirmed that the schematized alarm-managing manual can be useful for ICU nurses to resolve alarms and can be used as a guideline. Application of this manual to clinical practices and its use can therefore, be encouraged through continuous educationand promotion.

Keywords: Renal replacement therapy, Alarm, Manuals, Nurses, Competence

Figures and Tables

Figure 1
An example of the schematized alarm-managing manual.
jkana-20-535-g001
Table 1
General and CRRT-related Characteristics of Participants and Homogeneity of Two Groups (N=60)
jkana-20-535-i001

*Statistically analyzed by Fisher's exact test; Exp.=Experimental group; Cont.=Control group; ICU=Intensive care unit; CRRT=Continuous renal replacement therapy.

Table 2
Alarm Resolution Rate of the Participants (N=1345)
jkana-20-535-i002

Exp.=Experimental group; Cont.=Control group

Table 3
CRRT Nursing Competency of the Participants (N=60)
jkana-20-535-i003

Exp.=Experimental group; Cont.=Control group.

Table 4
Participants' Satisfaction with the Schematized Alarm-managing Manual (N=30)
jkana-20-535-i004

CRRT=Continuous renal replacement therapy.

Notes

This article is a revision of the first author's master's thesis from Sungkyunkwan University.

References

1. Tonelli M, Manns B, Feller-Kopman D. Acute renal failure in the intensive care unit: A systematic review of the impact of dialytic modality on mortality and renal recovery. Am J Kidney Dis. 2002; 40(5):875–885. http://dx.doi.org/10.1053/ajkd.2002.36318.
2. Dirkes SM. Continuous renal replacement therapy: Dialytic therapy for acute renal failure in intensive care. Nephrol Nurs J. 2000; 27(6):581–590. quiz 591-592.
3. Baldwin I, Fealy N. Clinical nursing for the application of continuous renal replacement therapy in the intensive care unit. Semin Dial. 2009; 22(2):189–193. http://dx.doi.org/10.1111/j.1525-139X.2008.00547.x.
4. Guenoun T, Journois D, Safran D. [Hemofiltration during severe sepsis or multiorgan failure syndrome]. Nephrologie. 1998; 19(2):83–88.
5. Seo JW, Park JS. Continuous renal replacement therapy. Korean J Crit Care Med. 2001; 16(2):115–118.
6. Bellomo R, Baldwin I, Golpe T, Ronco C. Trouble-shooting during CRRT: Clinical and technical problems. In : Bellomo R, editor. Atlas of hemofiltration. London: Saunders;2001. p. 69–76.
7. Baldwin I. Is there a need for a nurse emergency team for continuous renal replacement therapy? Contrib Nephrol. 2007; 156:191–196. http://dx.doi.org/10.1159/0000102083.
8. Ricci Z, Ronco C. Information technology for CRRT and dose delivery calculator. Contrib Nephrol. 2007; 156:197–202. http://dx.doi.org/10.1159/0000102084.
9. Baldwin I, Elderkin T, Bridge N. Nursing management concepts for CRRT in the ICU. In : Bellomo R, editor. Atlas of hemofiltration. New York: Saunders;2001. p. 83–95.
10. Berbece AN, Richardson RM. Sustained low-efficiency dialysis in the ICU: Cost, anticoagulation, and solute removal. Kidney Int. 2006; 70(5):963–968. http://dx.doi.org/10.1038/sj.ki.5001700.
11. Mulder J, Tan HK, Bellomo R, Silvester W. Platelet loss across the hemofilter during continuous hemofiltration. Int J Artif Organs. 2003; 26(10):906–912.
12. Bellomo R, Baldwin I, Fealy N. Prolonged intermittent renal replacement therapy in the intensive care unit. Crit Care Resusc. 2002; 4(4):281–290.
13. Graham P, Lischer E. Nursing issues in renal replacement therapy: organization, manpower assessment, competency evaluation and quality improvement processes. Semin Dial. 2011; 24(2):183–187. http://dx.doi.org/10.1111/j.1525-139X.2011.00835.x.
14. Dirkes S, Hodge K. Continuous renal replacement therapy in the adult intensive care unit: history and current trends. Critical Care Nurse. 2007; 27(2):61–80.
15. De Becker W. Starting up a continuous renal replacement therapy program on ICU. Contrib Nephrol. 2007; 156:185–190. http://dx.doi.org/10.1159/0000102082.
16. Gambro. Prisma Flex operator manual. Seoul: Gambro;2009. p. 103–161.
17. Lee SJ. Quality improvement in continuous renal replacement therapy. J Korean Soc Qual Assur Health Care. 2009; 2:101–103.
18. Kim HE. Development and evaluation of the web-based CRRT nursing education program [master's thesis]. Busan: Pusan National University;2012.
19. Langford S, Slivar S, Tucker SM, Bourbonnais FF. Exploring CRRT practices in ICU: A survey of Canadian hospitals. Dynamics. 2008; 19(1):18–23.
20. Park MH. Understanding and application of evidence based nursing. Seoul: Koonja Publishing;2006. p. 145–147.
21. Paul S. Developing practice protocols for advanced practice nursing. AACN Clinical Issues. 1999; 10(3):343–355.
22. Irons LR, Keel R, Bielema CL. Blended learning and learner satisfaction: Keys to user acceptance? USDLA J. 2002; 16(12):29–39.
23. Vijayan A. Vascular access for continuous renal replacement therapy. Semin Dial. 2009; 22(2):133–136.
24. Baldwin IC. Training, management, and credentialing for CRRT in the ICU. Am J Kidney Dis. 1997; 30(5):112–116.
25. Huang YC, Hsu LL. Critical care nurse learning of continuous renal replacement therapy: The efficacy of a self-learning manual. Hu Li Za Zhi. 2011; 58(1):37–47.
26. Mottes T, Owens T, Niedner M, Juno J, Shanley TP, Heung M. Improving delivery of continuous renal replacement therapy: Impact of a simulation-based educational intervention. Pediatr Crit Care Med. 2013; 14(8):747–754. http://dx.doi.org/10.1097/PCC.0b013e318297626e.
27. Mencia S, Lopez M, Lopez-Herce J, Ferrero L, Rodriguez-Nunez A. Simulating continuous renal replacement therapy: Usefulness of a new simulator device. J Artif Organs. 2014; 17:114–117. http://dx.doi.org/10.1007/s.10047-013-0743-z.
28. Lee HJ. Application and evaluation of a pressure ulcer prevention protocol for patients with open heart surgery [master's thesis]. Seoul: Yonsei University;2008.
29. Kim JE. A study of improvement of English reading comprehension ability through graphic organizers [master's thesis]. Seoul: Kookmin University;2013.
TOOLS
Similar articles