Strategic implementation for providing kidney replacement therapy during COVID-19 Meeting Abstract
| Authors: | Kong, E.; Casas, M. |
| Abstract Title: | Strategic implementation for providing kidney replacement therapy during COVID-19 |
| Meeting Title: | 47th Annual Congress of the Oncology Nursing Society (ONS) |
| Abstract: | The project objective was to describe our response to the COVID-19 pandemic to ensure uninterrupted kidney replacement therapy (KPT) for our acute kidney injury and chronic end-stage renal disease patient cohort. With the onset of the COVID-19 pandemic, our 514-bed NYC Magnet recognized NCI-designated comprehensive cancer center mobilized all patient care areas to meet the needs and safety of our patients and staff. As a result, a collaborative team inclusive of dialysis nurses, Renal and ICU management medical teams was developed to spearhead guidelines to improve KRT treatment outcomes for acutely ill and chronic end-stage renal disease patients. As the number of COVID-19 positive patients increased throughout the organization, strategic planning began with expanding the ICU by relocating the in-patient hemodialysis treatment area to a designated COVID-19 unit equipped to accommodate hemodialysis in private negative pressure rooms for both COVID-19 positive and non-COVID-19 patients. Early identification of our inability to secure additional continuous renal replacement therapy (CRRT) machines led to incorporating the use of shift therapy to optimize our available equipment, along with our supply chain preemptively increasing the purchase of CRRT and hemodialysis supplies. As the ICU expanded across two distinct units, nursing practice changes included setting up the CRRT equipment outside the COVID-19 positive patient's room, decreasing nursing exposure time, and obtaining CRRT waste line extension sets for use in rooms without designated drainage systems. To mitigate possible access issues, the right internal jugular was spared for dialysis catheter lines placement, and the use of a larger bore catheter became the standard of care. In addition, the policy for TPA dwell time was standardized to two hours to manage clotted or sluggish hemodialysis catheters. The dialysis unit comprised of only registered nurses, coordinating with essential departments to stock supplies for both the ICU and the temporary unit, providing terminal cleaning in-between patient treatments, and transporting patients between units was crucial. To increase our staffing, re-orientation was provided to a previously employed dialysis tech. In addition, the nursing staff of our relocated unit was all provided re-orientation on the Hemodialysis Emergency Disconnect procedures in the event of an adverse event. Throughout the pandemic, the hemodialysis nursing staff supported the ICU nurses as resources while providing CRRT for patients with acute kidney injury. |
| Keywords: | strategic planning; california; program implementation; renal replacement therapy; congresses and conferences -- california; covid-19 -- therapy |
| Journal Title: | Oncology Nursing Forum |
| Volume: | 49 |
| Issue: | 2 |
| Meeting Dates: | 2022 Apr 27-May 1 |
| Meeting Location: | Anaheim, CA |
| ISSN: | 0190-535X |
| Publisher: | Oncology Nursing Society (ONS) |
| Date Published: | 2022-03-01 |
| Start Page: | E14 |
| End Page: | E15 |
| Language: | English |
| DOI: | 10.1188/22.Onf.E2 |
| PROVIDER: | EBSCOhost |
| PROVIDER: | cinahl |
| PUBMED: | 35191905 |
| DOI/URL: | |
| Notes: | Meeting Abstract: P21 -- in PDF named "2022 ONS Congress Poster Abstracts" -- Source: Cinahl |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work