Abstract/Description/Artist Statement
Nurses in critical care environments must exercise precise clinical judgement to recognize patient destabilization cues while managing the complex biomedical technologies that support failing physiological systems. Continuous Renal Replacement Therapy (CRRT) is a modality for hemodynamically unstable patients requiring fluid overload management and waste removal; however, it is a complex technology that demands nurses navigate a “tightrope” between renal perfusion and hemodynamic stability. Despite its prevalence, there is no concise decision-making support for nursing care in the current literature based on the Quality and Safety Education for Nurses (QSEN) strategies. This presentation addresses this gap by proposing a QSEN-based, standardized decision-making framework and advocacy tool that provides anticipatory guidance for CRRT initiation and weaning, designed as a quick-reference tool for nurses new to critical care. It presents clinical indicators, such as hemodynamic and renal status, laboratory trends, and assessment findings, that suggest CRRT initiation is needed or readiness for weaning. It serves as a guide for nursing judgement and patient advocacy while remaining within provider-directed care. The utility of this approach is demonstrated through an anecdotal case study in a Cardiac Intensive Care Unit (CICU), where these tools contributed to a nurse-led, nephrology-ordered CRRT weaning. The findings from this case are promising and suggest these proposed tools can be useful for providing decision-making support for bedside critical care nurses and improving patient advocacy in critical care environments.
Faculty Advisor/Mentor
Dr. Beth Tremblay
Faculty Advisor/Mentor Email
bmtrembl@odu.edu
Faculty Advisor/Mentor Department
Ellmer School of Nursing
College/School Affiliation
Ellmer School of Nursing
Student Level Group
Undergraduate
Presentation Type
Poster
Included in
Cardiovascular Diseases Commons, Community Health and Preventive Medicine Commons, Public Health and Community Nursing Commons
Optimizing Continuous Renal Replacement Therapy (CRRT) in the ICU: A QSEN-Based Framework for Nursing Decision-Making Support
Nurses in critical care environments must exercise precise clinical judgement to recognize patient destabilization cues while managing the complex biomedical technologies that support failing physiological systems. Continuous Renal Replacement Therapy (CRRT) is a modality for hemodynamically unstable patients requiring fluid overload management and waste removal; however, it is a complex technology that demands nurses navigate a “tightrope” between renal perfusion and hemodynamic stability. Despite its prevalence, there is no concise decision-making support for nursing care in the current literature based on the Quality and Safety Education for Nurses (QSEN) strategies. This presentation addresses this gap by proposing a QSEN-based, standardized decision-making framework and advocacy tool that provides anticipatory guidance for CRRT initiation and weaning, designed as a quick-reference tool for nurses new to critical care. It presents clinical indicators, such as hemodynamic and renal status, laboratory trends, and assessment findings, that suggest CRRT initiation is needed or readiness for weaning. It serves as a guide for nursing judgement and patient advocacy while remaining within provider-directed care. The utility of this approach is demonstrated through an anecdotal case study in a Cardiac Intensive Care Unit (CICU), where these tools contributed to a nurse-led, nephrology-ordered CRRT weaning. The findings from this case are promising and suggest these proposed tools can be useful for providing decision-making support for bedside critical care nurses and improving patient advocacy in critical care environments.