e-Prescribing, Charting, and Documentation for Continuous Renal Replacement Therapy: A Green Intensive Care Unit and...

Area of Science:

• Nephrology
• Medical Informatics
• Critical Care Medicine

Background:

• The increasing digitization of patient care in intensive care units (ICUs) necessitates the integration of complex life-sustaining therapies.
• Continuous Renal Replacement Therapies (CRRTs) present unique challenges for digital integration due to their complexity and customization needs.
• The COVID-19 pandemic accelerated the drive towards paperless and environmentally friendly ICU practices.

Purpose of the Study:

• To design, develop, and implement a comprehensive digital system for CRRT within an existing electronic health record (EHR) system.
• To transition CRRT management from paper-based processes to a fully digital workflow, including ordering, charting, and monitoring.
• To enhance data accessibility and clinical decision-making for CRRT management in the ICU.

Main Methods:

• Development of custom digital modules for CRRT orders, charting, and real-time monitoring.
• Integration of the CRRT system with the existing Cerner EHR software.
• Role-specific interface design for medical, nursing, and pharmacy personnel.

Main Results:

• Successful implementation of a digital CRRT system, replacing traditional paper documents.
• Introduction of a live dashboard with new metrics and data, linked to patient fluid balance, pathology, and medication records.
• Positive initial evaluation, leading to the development of an audit trail and provision for concurrent therapies.

Conclusions:

• The developed digital system enhances CRRT management through improved data visualization and accessibility.
• Clinicians utilize the live data for improved patient handovers and case discussions.
• This initiative provides a model for other institutions seeking to implement digital CRRT solutions for "green nephrology" in ICUs.