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Published byBelinda Black Modified over 9 years ago
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Current State of Pediatric Continuous Renal Replacement Therapy (PCRRT): A National Survey AJ Tanner, RN, BSN, ML Heard, RN, TL Young, RN, BSN, SF Wagoner, MBA, RRT April J. Tanner, RN, BSN Advanced Technologies Coordinator Children’s Healthcare of Atlanta at Egleston
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A National Survey An national review of current trends in CRRT An 18 question survey sent to pediatric centers that offer CRRT free-standing or based in adult facility 42 centers responded
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Therapy Types
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22 of 42 centers offer all available therapies Mean PCRRT pts per year: 12.8 (1-60) Median pts per year: 9 50% of centers have <10 patients per year Average daily census of ICU’s: 13 range of 5-27
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System Set-up
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Staffing Ratios
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Logistics and Coordination of System Set-up 11 of 42 centers have no formal 24/7 coverage In 93% of center’s RNs manage the pump dialysis, ECMO, and physicians make up the other % Charge structure the dept.that sets up equipment receives revenue in majority of centers 21 of 42 centers also have daily charges varied response as to where revenue goes
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Managing the Program
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Education Wide variety of teaching methods Didactic/hands on skills lab training occurs in 69% of initial training sessions 12% require mentoring shifts 17% offer informal training 7% utilize bedside training methods
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Education Annual recertification - 43% More frequent recertification occurs 26% smaller volume programs 19% of programs have no formal annual competency or recertification programs Many centers education programs are under review
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Equipment
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Equipment and Supplies Solutions Custom made - 36% Normocarb - 31% Remaining centers used a combination of normocarb and custom or prismanate Med-comp is the catheter of choice in 45% of programs
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Anticoagulation 40% utilize citrate 13 of 16 centers have converted from heparin to citrate within the last 2 years Centers using both change depending on patient needs
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What does all of this tell us? Variable approaches to therapy, training, methods, equipment and supplies National certification programs help with consistency in training PCRRT Registry potential to help standardize management develop protocols review outcomes
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