title: Developing an intervention to prevent acute kidney injury: using the Plan, Do, Study, Act (PDSA) service improvement approach.
abstract: BACKGROUND
  In the UK, recent National Institute for Health and Care Excellence guidelines for acute kidney injury point to the need for interventions to help prevent this condition. Effective medicines management is of prime importance in reducing the risk of AKI. Part of this challenge is to increase patients' awareness of their medicines and the possible need to temporarily withhold certain medications when acutely unwell.
  
  
  OBJECTIVE
  The objectives were to use a service improvement approach (the Plan, Do, Study, Act cycle) to develop an intervention and to evaluate current delivery of acute kidney injury management and to test and generate new ideas relating to patients' needs.
  
  
  METHODS
  A postal feedback form sent to a random sample of over 200 patients with chronic kidney disease.
  
  
  METHODS
  The feedback form collected information on: what patients know about acute kidney injury and managing medicines; where patients get their information from; whether patients want more information and where from; and what patients feel about self-managing their medicines.
  
  
  RESULTS
  Completed feedback forms were received from 113 participants. Of these, 92% said they had received no advice, 77% of respondents wanted more advice but only 17% said they would feel comfortable to stop their own medication without medical consent.
  
  
  CONCLUSIONS
  The PDSA cycle offered a very useful framework to evaluate the current service delivery and to test and generate new ideas for the development of an AKI intervention. Our findings highlighted that the current service is limited and more robust research is needed.
authors.affiliation: Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, Leicestershire, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Byrne
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.forename: Sue
authors.initials: S
authors.lastname: Carr
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000451:nursing* / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000451:nursing* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic; D055553:Prescription Drugs / Q000009:adverse effects*; D058996:Quality Improvement / Q000458:organization & administration*; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D055553:Prescription Drugs
keywords: Acute kidney injury; Medicine management; Quality improvement; Self-management