Reduction of Intradialytic Complications Using Interactive Fluid Volume Technology

Abstract

The Reduction of Intradialytic Complications Using Interactive Fluid Volume Technology is a quality improvement (QI) project that used Crit-line technology to manage intradialytic fluid volume during hemodialysis at the project site. Improved patient blood volume management during hemodialysis is instrumental in shortening the length of inpatient hospital stays for hemodialysis patients, decreasing fluid volume overload, and limiting intradialytic adverse events while improving the utilization of existing resources. The goal of this project is to fully integrate existing Crit-line technology, an FDA-approved medical device, to improve euvolemia in hemodialysis patients during their inpatient stay. Specific areas addressed in this project included changes to the current hemodialysis order set, provider training, and nursing education. All adult patients receiving hemodialysis during the six-week implementation period were included in this project. Evaluation measures included the utilization of the order set modifications by the providers ordering hemodialysis and if the optimal Crit-line profile was met during each hemodialysis treatment using the modified order set. During the implementation period, data was collected weekly through order set utilization review within the electronic medical record, ending Crit-line profile within the hemodialysis service provider’s billing software, and intradialytic complications were identified through chart reviews. The utilization of the modified order set exceeded the initial project goal and continues to remain at approximately 70%. Key project findings included enhanced volume assessment during hemodialysis, decreased intradialytic complications, increased nurse autonomy, and improved workflow for providers and nursing staff.