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Reducing hyperkalemia in hemodialysis: a nurse-led quality improvement project using the clinical translation model
Yanhua Jiang1,2, Chunhua Sun1, Xuan Shen1
1Department of Nursing, Shanghai General Hospital, Shanghai, China.
Introduction:
Despite guidelines, hyperkalemia remains a major risk in hemodialysis patients due to an evidence-practice gap.
Aim:
This study aimed to implement evidence-based hyperkalemia management, reduce the incidence of hyperkalemia, and evaluate its implementation effects.
Methods:
Using the Fudan University Evidence-Based Nursing Center's Clinical Translation Model and the Ottawa Model of Research Use, best evidence was integrated into practice. Strategies included revised protocols, assessment tools, and education. Outcomes were measured pre- and post-implementation.
Results:
Staff and patient knowledge scores significantly increased. Adherence to all 39 quality indicators improved. After 6 months, patient compliance increased, pre-dialysis serum potassium levels decreased, hyperkalemia incidence dropped from 61.7% to 34.4%, and adverse events declined.
Conclusions:
This nurse-led, model-guided implementation project successfully bridged the evidence-practice gap, enhancing competency and compliance while significantly reducing hyperkalemia rates and associated risks, providing a replicable model for improving hemodialysis patient safety.
Spanish Abstract:
http://links.lww.com/IJEBH/A649.
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