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Published on: November 3, 2023
Success in Reducing Acute Kidney Injury Post-Percutaneous Coronary Intervention
Jacob Anthuvan1, Patricia Blake2, Danielle Blais3
1The Ohio State University School of Medicine, Columbus, Ohio, USA.
Insights
Implementing a quality initiative to address acute kidney injury (AKI) after percutaneous coronary intervention (PCI) significantly reduced AKI rates. This project identified and resolved hydration delivery delays, improving patient outcomes.
Area of Science:
- Cardiology
- Nephrology
- Quality Improvement
Background:
- Acute kidney injury (AKI) following percutaneous coronary intervention (PCI) is linked to adverse patient outcomes.
- In 2018, the hospital's AKI rate was in the lower quartile nationally, indicating a need for improvement.
Background:
Acute kidney injury (AKI) after percutaneous coronary intervention (PCI) contributes to short- and long-term adverse events. In 2018, our rate for AKI was in the lower quartile for several quarters compared to other hospitals in the American College of Cardiology National Cardiovascular Data Registry Cath/PCI Registry.
Project Rationale:
Our quality initiative (QI) project was to understand factors contributing to AKI and opportunities to improve this outcome.
Project Summary:
A significant delay to the initiation and volume of hydration administered in patients with AKI as compared to without AKI post-PCI was discovered. Lack of understanding hydration order set, fear of volume overload, hydration communication handoff deficiencies, and order-release process variation were contributing factors. Appropriate and sustainable interventions were made improving AKI post-PCI.
Take-Home Messages:
A successful QI project requires a multidisciplinary team identifying barriers and deriving solutions. Our QI project resulted in AKI post-PCI improving to the 90th percentile for 9 consecutive quarters.
Related Concept Videos
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Acute Kidney Injury V: Interprofessional Care
Cardiac Catheterization I: Pre-Procedure Overview
Acute Coronary Syndrome IV: Interprofessional Care
Acute Kidney Injury I: Introduction
Acute Kidney Injury II: Pathophysiology

