title: Implementing continuous quality improvement strategies for improving iron replacement in hemodialysis patients.
abstract: Anemia associated with end stage renal disease can diminish quality of life substantially. Maintaining a stable hematocrit and stable hemoglobin levels affords many advantages. Improvement of anemia management is possible with the implementation of continuous quality improvement (CQI). Our review of the literature motivated us to switch from iron dextran injection, which can induce anaphylactic reactions and has other associated problems, to sodium ferric gluconate complex injection. This enables us to safely provide iron supplementation without the precautions that were in place for iron dextran. Our methods for creating and implementing CQI in the dialysis program at our university hospital are described.
authors.affiliation: Nephrology Hospital Services and Satellite Services, Dialysis Center at Bethpage, Bethpage, NY, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Trenkle
mesh_terms: D000465:Algorithms; D000707:Anaphylaxis / Q000139:chemically induced; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D003663:Decision Trees; D004921:Erythropoietin / Q000627:therapeutic use; D005290:Ferric Compounds / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007505:Iron-Dextran Complex / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D017749:Total Quality Management / Q000458:organization & administration*; D014168:Transferrin / Q000378:metabolism
chemical_list: D005290:Ferric Compounds; D006454:Hemoglobins; D014168:Transferrin; D004921:Erythropoietin; D007505:Iron-Dextran Complex; D005293:Ferritins; C035552:ferric gluconate