Table 1

PDSA cycles

PDSA cycle1234
AimEstablish reliability of scoring tool and accuracy completing the AKI risk scoreImprove accuracy completing the AKI risk scoreImprove compliance with completing the AKI risk scoreAssess compliance with intervention bundle
InterventionAKI 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 AKICoincided 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 scoreJunior and senior orthopaedic staff briefed at daily trauma meeting with demonstration of scoring and explanation of bundle rationaleCollect 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 collection461318
OutcomeThree of four patients had score completed, correct in only one patient. Errors due to incorrect ASA grade being usedDrop in compliance completing the score (2/6). The score was completed accuratelySignificant 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.