Prevention of unplanned interruption in critically ill continuous renal replacement therapy patients:a best practice implementation project

Abstract Backgrund: Renal impairment is a common complication in critically ill patients after cardiac surgery, and Continuous Renal Replacement Therapy (CRRT) is the primary treatment. Aims This study used the Knowledge to Action Framework(KTA) to explore the impact of an evidence-based nursing practice protocol on single filter longevity, complications, and the chance of unplanned interruption in critically ill CRRT patients. Methods This was a non-simultaneous controlled study and included 61 medical personnel and 90 patients. 45 pre-practice and 45post-practice patients were divided into control and intervention groups. The evidence-based practice program was developed by the evidence-based nursing process, and the best evidence application strategy was constructed based on the KTA framework for clinical practice change at the development organization level, practice level, and patient level. The knowledge, trust and behavior scores of medical personnel were analyzed before and after the evidence-based practice, and the filter life span, complication rate, and unplanned interruption rate of patients between the two groups. Results Before the evidence-based intervention, there was no difference in the comparison of patients' basic information between the two groups (p > 0.05). After the evidence-based intervention, the patients' individual filter service life was significantly prolonged (p < 0.001), and the complication rate was significantly reduced (p = 0.003). The intervention group had a lower chance of unplanned CRRT than the control group (p < 0.001). The scores of medical personnel's knowledge, trust and behavior were all higher than before the intervention (p < 0.001). Conclusions Evidence-based nursing practice prolongs the life of individual filters in critically ill CRRT patients, reduces complication rates, and can prevent unplanned interruption with good clinical validity.