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Title: An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.
Authors: Xu, Gang
Baines, Richard
Westacott, Rachel
Selby, N.
Carr, Susan
First Published: 20-Mar-2014
Publisher: BMJ Publishing Group
Citation: BMJ Open 2014;4:e004388
Abstract: Objective To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). Setting 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. Participants All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. Interventions A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. Outcome measures We assessed clinicians’ knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. Results 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, p<0.001). There was an improvement in the number of clinicians reporting satisfactory practice when diagnosing AKI, 50% vs 68% (χ²=12.1, p<0.001) and investigating patients with AKI, 48% vs 64% (χ²=9.5, p=0.002). Clinical audit makers showed a trend towards better clinical practice. Conclusions This quality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.
DOI Link: 10.1136/bmjopen-2013-004388
ISSN: 2044-6055
eISSN: 2044-6055
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Description: PMCID: PMC3963099
Appears in Collections:Published Articles, Dept. of Infection, Immunity and Inflammation

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