title: Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: protocol for a systematic review.
abstract: BACKGROUND
  Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively resource-intensive and expensive technology, there remains wide practice variation in its application. This systematic review will appraise the evidence for quality indicators (QIs) of CRRT care in critically ill patients.
  
  
  METHODS
  Ovid MEDLINE, Ovid EMBASE, CINAHL, and the Cochrane Library including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), and databases from the National Information Center of Health Services Research and Health Care Technology will be searched for original studies involving QIs in CRRT. Gray literature sources will be searched for technical reports, practice guidelines, and conference proceedings. Websites of relevant organizations will be identified, and industry leaders in the development and marketing of CRRT technology and non-profit organizations that represent key opinion leads in the use of CRRT will be contacted. We will search the Agency of Healthcare Research and Quality National Quality Measures Clearinghouse for CRRT-related QIs. Studies will be included if they contain quality measures, occur in critically ill patients, and are associated with CRRT. Analysis will be primarily descriptive. Each QI will be evaluated for importance, scientific acceptability, usability, and feasibility using the four criteria proposed by the United States Strategic Framework Board for a National Quality Measurement and Reporting System. Finally, QIs will be appraised for their potential operational characteristics, for their potential to be integrated into electronic medical records, and on their affordability, if applicable.
  
  
  CONCLUSIONS
  This systematic review will comprehensively identify and synthesize QIs in CRRT. The results of this study will fuel the development of an inventory of essential QIs to support the appropriate, safe, and efficient delivery of CRRT in critically ill patients.
  
  
  BACKGROUND
  PROSPERO CRD42015015530.
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada. rewa@ualberta.ca.
authors.forename: Oleksa
authors.initials: O
authors.lastname: Rewa
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada. villeneu@ualberta.ca.
authors.forename: Pierre-Marc
authors.initials: PM
authors.lastname: Villeneuve
authors.affiliation: 2-040 Li Ka Shing Center for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, Alberta, Canada. deurich@ualberta.ca.
authors.forename: Dean T
authors.initials: DT
authors.lastname: Eurich
authors.affiliation: Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada. tstelfox@ucalgary.ca.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada. ngibney@ualberta.ca.
authors.forename: R T Noel
authors.initials: RT
authors.lastname: Gibney
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, Aberhart Centre, Room 8417, Edmonton, Alberta, T6G 1Z1, Canada. hartling@ualberta.ca.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hartling
authors.affiliation: Alberta Research Center for Health Evidence (ARCHE), University of Alberta, 4-486D Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada. feathers@ualberta.ca.
authors.forename: Robin
authors.initials: R
authors.lastname: Featherstone
authors.affiliation: Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada. bagshaw@ualberta.ca.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bagshaw
mesh_terms: D016638:Critical Illness / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units; D019984:Quality Indicators, Health Care; D017582:Renal Replacement Therapy; D012107:Research Design; D000078202:Systematic Reviews as Topic; D014481:United States