Semester

Fall

Date of Graduation

2022

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Department

Not Listed

Committee Chair

Aaron Ostrowski

Committee Co-Chair

John Gotses

Committee Member

John Gotses

Abstract

Background: Continuous renal replacement therapy (CRRT) is a complex, life-preserving treatment for unstable patients who require hemodialysis in the intensive care unit (ICU). Nurses responsible for managing the CRRT machine in this large academic medical center’s cardiovascular ICU (CVICU) complete a one-hour basic training course focused on setting up the machine, responding to basic alarms, and changing out the CRRT circuit when necessary. Staff nurses, advanced practice providers (APPs), and nursing administrators agree that training is insufficient. Research evidence supports rigorous staff training as essential to improving the quality of CRRT delivery. Purpose: This Doctor of Nursing Practice (DNP) project purposed to implement an advanced CRRT training program for nurses and APPs in the hospital’s CVICU to (a) increase participants’ CRRT knowledge and to improve management and troubleshooting skills; (b) improve CRRT delivery in the CVICU; (c) evaluate participants’ perception of training program effectiveness. Intervention: An advanced CRRT training program was implemented. Participants attended a four-hour CRRT training course provided by the clinical educator for the CRRT machine manufacturer. Methods: To assess the impact of the intervention on CRRT knowledge, participants completed a CRRT knowledge test before and after the training course. To assess the impact of the intervention on CRRT delivery, post-intervention data from the CRRT machines was compared to pre-intervention data for the following CRRT-specific outcomes of interest: downtime, dosing target accuracy, filter life, number of unnecessary filter changes, filters used per treatment day, and filter expense. To assess the impact of the intervention on perceived competency, participants were asked to complete pre- and post-intervention surveys. Statistical analyses were performed to compare pre-intervention to post-intervention data. Results: The advanced CRRT training course was attended by 25 participants. Participants had a statistically significant increase in knowledge as evidenced by the difference between pre- (59.37%, SD=8.46%) and post-intervention (82.54%, SD=6.63%) CRRT knowledge test scores (p=Conclusions: Implementation of an advanced training program is an essential first step toward increasing nurses’ knowledge and improving CRRT management and troubleshooting skills.

Download

Share

COinS