Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Crit Care. 2019 Dec;54:52-57. doi: 10.1016/j.jcrc.2019.07.003. Epub 2019 Jul 5.
There is wide variation in the practice of acute renal replacement therapy (RRT). Quality of care is suboptimal, and substantial knowledge-to-care gaps need to be addressed. The quality of care for patients receiving acute RRT has been recognized as a clinical and research priority. Quality indicators (QIs) can be implemented to measure the quality of care received by patients and further be used as targets for continuous quality improvement initiatives focused on the prescription, delivery, and monitoring of acute RRT care.
The 22nd ADQI meeting was held in San Diego, USA, from October 28th to 30th 2018. Prior to the meeting, a literature review was conducted, and 3 teleconferences were held to develop research questions and consensus statements. These were presented at the meeting and refined before being approved by all ADQI delegates.
Four research questions and fifteen consensus statements were generated. These focused on monitoring the quality of acute RRT along with the Donabedian quality measure domains of structure, process, and outcome. Recommendations for clinical practice and a research agenda for each question were also proposed.
Currently, there remains few validated QIs for acute RRT. These need further evaluation, need benchmarks established, and ultimately require implementation into clinical practice.
急性肾脏替代治疗（RRT）的实践存在广泛差异。护理质量不尽如人意，需要解决大量知识与护理之间的差距。接受急性 RRT 的患者的护理质量已被视为临床和研究的重点。质量指标（QIs）可用于衡量患者接受的护理质量，并进一步用作关注急性 RRT 护理的处方、提供和监测的持续质量改进计划的目标。
第 22 届 ADQI 会议于 2018 年 10 月 28 日至 30 日在美国圣地亚哥举行。会议前进行了文献回顾，并举行了 3 次电话会议，以提出研究问题和达成共识声明。这些问题在会议上提出，并在所有 ADQI 代表批准之前进行了细化。
提出了四个研究问题和十五个共识声明。这些问题侧重于监测急性 RRT 的质量，以及 Donabedian 质量衡量结构、过程和结果领域。还为每个问题提出了临床实践建议和研究议程。
目前，急性 RRT 的验证 QIs 很少。这些需要进一步评估，需要建立基准，并最终需要实施到临床实践中。
