title: An electronic alert to decrease Kayexalate ordering.
abstract: Important safety concerns have recently emerged regarding the use of sodium polystyrene sulfonate (Kayexalate), a cation-exchange resin commonly used for the treatment of hyperkalemia. We implemented an electronic alert system at a tertiary care academic medical center to warn providers of the safety concerns of Kayexalate. We assessed the number of Kayexalate prescriptions per month, as well as the number of grams of Kayexalate ordered per month, one year before versus one year after implementing the alert. The mean (±SD) number of Kayexalate orders decreased from 123 (±12) to 76 (±14) orders/month (38% absolute reduction, p < 0.001) after implementing the alert. Additionally, the mean (±SD) amount of Kayexalate prescribed decreased from 3332 (±329) to 1885 (±358) g/month (43% absolute reduction, p < 0.001). We conclude that an electronic alert is an effective tool to decrease Kayexalate ordering.
authors.affiliation: a Division of Renal Medicine , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Leaf
authors.affiliation: b Department of Medicine , Massachusetts General Hospital , Boston , MA , USA.|c Division of Nephrology , Stanford University , Palo Alto , CA , USA.
authors.forename: Xingxing S
authors.initials: XS
authors.lastname: Cheng
authors.affiliation: d Harvard Affiliated Emergency Medicine Residency, Brigham and Women's Hospital and Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Jason L
authors.initials: JL
authors.lastname: Sanders
authors.affiliation: a Division of Renal Medicine , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Mallika
authors.initials: M
authors.lastname: Mendu
authors.affiliation: e Division of General Internal Medicine , Center for Patient Safety Research and Practice, Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Schiff
authors.affiliation: a Division of Renal Medicine , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Mount
authors.affiliation: b Department of Medicine , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Hasan
authors.initials: H
authors.lastname: Bazari
mesh_terms: D002411:Cation Exchange Resins / Q000009:adverse effects*; D016903:Drug Monitoring / Q000379:methods*; D004363:Drug Utilization / Q000639:trends; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy*; D008404:Massachusetts; D050316:Medical Order Entry Systems; D061214:Patient Safety; D011137:Polystyrenes / Q000009:adverse effects*; D058996:Quality Improvement; D062606:Tertiary Care Centers
chemical_list: D002411:Cation Exchange Resins; D011137:Polystyrenes; C003321:polystyrene sulfonic acid
keywords: Electronic alert; hyperkalemia; patient safety; potassium; quality improvement