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Helping combat acute kidney injury

11 April 2019

It is estimated that across the UK, 20% of all patients admitted to hospital have Acute Kidney Injury (AKI). AKI is a major cause of illness and death especially among our elderly population.

AKI is a condition where there is a rapid decline in kidney function and this means that the kidneys do not regulate fluid, electrolyte and acid base balance.

In order to improve the outcomes of patients with AKI, Southend University Hospital has recruited Linda Lio as its first dedicated AKI Nurse in September 2018.

Linda is also the lead for the AKI work stream at Basildon and Mid Essex, and meets regularly with the work stream members to discuss and agree on AKI pathways across the three trusts.

The prevention, early recognition and correct management of AKI can prevent serious complications, such as the need for dialysis temporarily or even permanently.

AKI is predictable, avoidable and can be treated in most cases. Some of the common causes of AKI are infection, kidney stones, dehydration, low blood pressure and certain medications. Common risk factors include patients aged 75 and above, or with cardiac failure, liver failure or diabetes mellitus.

Linda said: "Acute Kidney Injury is a huge patient safety issue. We can prevent, predict and treat it. In the month of February, 88% of the patients with AKI had it on arrival to A&E.  The good news is that we are already seeing improvements here at Southend Hospital as a result of implementing and following the AKI pathway.

"I see myself as a supportive role for all staff. Although AKI is potentially life-threatening, with the support and teaching that the staff get, they can understand that they will be able to make a difference. Everyone can make a difference, from HCAs, to nurses and  doctors. My job is to enable people to make that difference.

"That can be by doing a task as simple as using a urine dipstick to help alert medical staff that a patient may have something serious going on in their kidney and investigate the patient promptly.  It is also important that we look out for our patients and ensure that they are well hydrated in hospital by monitoring their hydration status."

The nursing care plans for AKI and the AKI policy can be found on the staff intranet. AKI teaching sessions are offered to healthcare support workers (HCSW) and newly qualified nurses (NQN) in their induction programmes. AKI teaching sessions are being offered at ward level as well. There will be teaching sessions to book via ilearn from April onwards for nurses and health care assistants.

Pictured -  Dr Gowrie Balasubramaniam and Linda Lio