Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety.
BACKGROUND
Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year.


OBJECTIVE
To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures.


METHODS
Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions.


RESULTS
Compared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material.


CONCLUSIONS
Standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Peggy
P
Lambert
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Kristine
K
Chaisson
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Susan
S
Horton
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Carmen
C
Petrin
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Emily
E
Marshall
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Sue
S
Bowden
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Lynn
L
Scott
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Sheila
S
Conley
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Janette
J
Stender
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Gertrude
G
Kent
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Ellen
E
Hopkins
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Brian
B
Smith
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Anita
A
Nicholson
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Nancy
N
Roy
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Brenda
B
Homsted
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Cindy
C
Downs
Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.|Kristine Chaisson is a nurse and executive director of the Central Maine Heart and Vascular Center, Central Maine Medical Center, Lewiston, Maine.|Susan Horton is a nurse and cardiac director and Nancy Roy is the nurse manager of the cardiac intensive care unit, Central Maine Medical Center.|Sheila Conley is a nurse database manager and Janette Stender is a cardiovascular medicine nurse practitioner at Dartmouth-Hitchcock Medical Center.|Ellen Hopkins and Gertrude Kent are ambulatory cardiac care nurses, Maine Medical Center, Portland, Maine.|Anita Nicholson is a cardiac catheterization nurse and Brian Smith is a cardiac catheterization technician, Wentworth Douglass Hospital, Dover, New Hampshire.|Cindy Downs and Brenda Homsted are nurses, Eastern Maine Medical Center, Bangor, Maine.|Cathy S. Ross is administrative director, Northern New England Cardiovascular Disease Study Group and manager of research projects at Dartmouth-Hitchcock Medical Center.|Jeremiah Brown is an associate professor and Emily Marshall is a research assistant, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, the Department of Medicine, and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. He is the principal investigator of the quality improvement project.
Cathy S
CS
Ross
Jeremiah
J
Brown
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000451:nursing / Q000517:prevention & control*; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England; D024802:Nurse's Role; D010353:Patient Education as Topic / Q000379:methods; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D036301:Qualitative Research; D058996:Quality Improvement; D018570:Risk Assessment
D003287:Contrast Media