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A patient safety alert has been issued today (9 June 2014) by NHS England on standardising the early identification of Acute Kidney Injury (AKI). The alert has been issued to all NHS acute trusts and foundation trusts providing pathology services.
A national algorithm, standardising the definition of AKI has now been agreed. This provides the ability to ensure that a timely and consistent approach to the detection and diagnosis of patients with AKI is taken across the NHS.
This algorithm has been endorsed by NHS England and it is recommended that the algorithm is implemented across the NHS. When integrated into a Laboratory Information Management System (LIMS) the algorithm will identify potential cases of AKI from laboratory data in real time and produce a test result. The laboratory system will then send the test result, using existing IT connections to patient management systems.
Acute kidney often occurs when a person with longstanding medical problems becomes unwell for other reasons, such as infection or dehydration. Kidney function rapidily reduces and mild AKI increases the risk of harm to an individual with an increased risk of death and the need for more complicated treatment.
Dr Mike Durkin, National Director of Patient Safety, NHS England, said: “This patient safety alert will ensure steps are taken in hospitals across England to improve the detection and diagnosis of AKI. It is estimated that one in five emergency admissions into hospital are associated with AKI, prolonging inpatient care and contributing to around 100,000 deaths. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) estimates that a quarter to a third of cases have the potential to be prevented and early detection and the standardisation of defining AKI is a big step towards achieving this.”
Dr Richard Fluck, National Clinical Director for Renal Services, NHS England, added: “We need to help the public, patients and professionals understand what acute kidney injury is and why it is important. This is a global healthcare issue and the NHS is leading the way in measuring the scale of acute kidney injury and the impact on individuals and the population. We need to identify people who are at risk, monitor them appropriately, diagnose the problem early and provide reliable and consistent treatment to everyone.”
NHS England in partnership with the UK Renal Registry has launched a National AKI Prevention Programme which will include the development of tools and interventions. A priority for the programme is the development and adoption of e-alert systems, based on the test result, which will proactively notify clinicians when a patient has AKI, supporting implementation of AKI NICE guidance.