1. AKI alerts on ICE at the Luton and Dunstable Hospital

2. AKI E-alerts at the L&D
E-alerts for AKI stages 1, 2 and 3 are based on the change in serum creatinine result from the previous result
E-alerts are automatically generated by ICE
Follow the instructions and clear the alert

3. Acute Kidney Injury E-alerts
Stage
Increase in serum Creatinine 1
1.5 x previous result 2
2 x previous result 3
≥3 x previous result

4. Limitations of the AKI e-alert system
Multiple alerts will show if AKI alert is for stages 2 or 3 ALWAYS accept the highest ranking alert eg. AKI stage 3 alert; AKI stage 1 & 2 alerts also show eg. AKI stage 2 alert; AKI stage 1 alert will also show
AKI alerts are based on the change in serum creatinine from the previous result which may NOT reflect the patient’s true baseline
You have to go to the patient’s results on ICE in order to see the e-alert

5. Limitations of the AKI e-alert system
The severity of AKI may be missed if there are multiple serum creatinine results within a short time period
Eg. Over 24 hours a patient’s serum creatinine (umol/L) changes as follows: > AKI stage 1 alert > AKI stage 1 alert
> AKI stage 1 alert
The change in serum creatinine from the previous result is only >1.5 therefore generating an AKI stage 1 alert
HOWEVER the change in serum creatinine from the first to the last result is >3 indicating the patient has AKI stage 3
Always review the trend in serum creatinine when assessing patient’s for AKI

6. Limitations of the AKI e-alert system
AKI alerts may be generated and the patient does not have AKI
Eg. Over 24 hours a patient’s serum creatinine (umol/L) changes as follows: > No alert > AKI stage 1 alert
> No alert The second result is not in keeping with the patient’s baseline
An AKI stage 1 alert is generated as the change from the previous result of 60 umol/L was >1.5. The change was a return to the patient’s baseline
Always review the trend in serum creatinine when assessing patient’s for AKI

7. What should I do when I see an
AKI alert on ICE?

8. The AKI alert on ICE Colour tells you the severity of the alert
Alert symbol

9. 1. Click on the alert symbol

10. 2. All alerts on the patient are displayed

11. AKI stage 3 > AKI stage 2 > AKI stage 1
4. Follow instructions for highest ranking alert
AKI stage 3 > AKI stage 2 > AKI stage 1

12. 5. To acknowledge an alert: Click on ‘Clear’ next to the alert

13. IMPORTANT
Once you have seen an AKI alert please follow the instructions on the alert
Follow instructions for the HIGHEST ranking alert (AKI stage 3 > AKI stage 2 > AKI stage 1)
Please clear ALL AKI alerts on the patient at that time

14. Further Information
AKI Documents on intranet
Trust AKI guidelines
Trust AKI Management Care Bundle
AKI prevention e-learning