Zasuwa Gerard A, Yee Jerry, Passalacqua Karla D, Frinak Stanley
Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan.
Kidney Med. 2022 Mar 18;4(5):100452. doi: 10.1016/j.xkme.2022.100452. eCollection 2022 May.
The Henry Ford Health System provides patients with a safe, improved system of continuous kidney replacement therapy using a proprietary, 24-hour sustained low-efficiency dialysis (SLED). The SLED system utilizes regional citrate anticoagulation (RCA) in conventional hemodialysis machines that have been configured to provide slow dialytic therapy. Within our hospital complex, SLED-RCA systems are deployed in intensive care units distributed over 4 floors in 2 buildings. This widespread footprint represents a spatial challenge for hemodialysis technicians. Fifteen SLED-RCA machines may be running at one time, and each deployed unit may signal an alarm for multiple reasons. Previously, audible alarms prompted intensive care unit nurses to identify the alarming machine and manually notify technicians by telephone. Technicians would then travel to resolve the alarm. To improve the process of addressing SLED-RCA machine alarms, we developed a remote alert alarm system that wirelessly notifies hemodialysis technicians of specific machine alarms. A quality improvement analysis of nearly 1,000 SLED-RCA alarms over a 1-week period revealed that the average time for alarm correction with a remote alert alarm system was approximately 5 minutes. Reducing alarm resolution time may free technicians and nurses for other critical duties.
亨利·福特医疗系统为患者提供了一种安全、改良的持续性肾脏替代治疗系统，该系统采用了一种专利性的24小时持续性低效透析（SLED）技术。SLED系统在经过配置以提供缓慢透析治疗的传统血液透析机中采用局部枸橼酸盐抗凝（RCA）技术。在我们的医院综合体内，SLED-RCA系统部署在分布于2栋楼4层的重症监护病房中。这种广泛的分布给血液透析技术人员带来了空间上的挑战。15台SLED-RCA机器可能会同时运行，并且每个已部署的设备可能会因多种原因发出警报。以前，声音警报会促使重症监护病房的护士识别发出警报的机器，并通过电话手动通知技术人员。然后技术人员会前往解决警报问题。为了改进处理SLED-RCA机器警报的流程，我们开发了一种远程警报系统，该系统可无线通知血液透析技术人员特定的机器警报。对1周内近1000次SLED-RCA警报进行的质量改进分析表明，使用远程警报系统纠正警报的平均时间约为5分钟。缩短警报解决时间可能会使技术人员和护士能够腾出时间去履行其他关键职责。
