PDSA cycle | 1 | 2 | 3 | 4 |
Aim | Establish reliability of scoring tool and accuracy completing the AKI risk score | Improve accuracy completing the AKI risk score | Improve compliance with completing the AKI risk score | Assess compliance with intervention bundle |
Intervention | AKI risk score introduced with electronic tool for calculating it on desktop and mobile devices available along with an intervention bundle for patients at high risk of AKI | Coincided with junior doctor change-over. Face-to-face education session with new doctors, highlighted guidance in scoring tool on ASA grading to ensure accuracy completing the score | Junior and senior orthopaedic staff briefed at daily trauma meeting with demonstration of scoring and explanation of bundle rationale | Collect data on larger sample. Presentation of preliminary results at department audit meeting and ongoing verbal encouragement given to junior staff |
Number of patients in data collection | 4 | 6 | 13 | 18 |
Outcome | Three of four patients had score completed, correct in only one patient. Errors due to incorrect ASA grade being used | Drop in compliance completing the score (2/6). The score was completed accurately | Significant improvement with 10/13 patients scored having score complete; 9 of those scored were accurate | 12/18 patients scored. All scores accurate and stickers applied to all high-risk notes |
AKI, acute kidney injury; ASA, American Society of Anaesthesiologists.