What did we do?

We evaluated an initiative aimed to raise the profile and potentially prevent cases of acute kidney injury (AKI) and optimise vascular health in primary care.

 

Why is it important?

Up to one in five emergency admissions into hospital are associated with AKI, with evidence of increased frequency, intensity and duration of hospitalisation. AKI is a syndrome which is common, harmful, costly and preventable, and it is associated with significantly worse short and long-term outcomes.

 

How did we do it?

The overall aim of the project was to deliver and evaluate the process of implementation of the sick day guidance card initiative.

 

Phase 1: A sick day guidance card was administered by general practices and community pharmacists to some patients who may have benefited from stopping certain medicines (those listed on the cards) during illness (to avoid damaging the kidneys).

 

Phase 2: Medicine management/practice pharmacists in primary care implemented kidney health initiatives to support AKI prevention.

 

We analysed the implementation of the sick day guidance cards in general practice and community pharmacy, and determined the factors influencing the implementation of kidney health initiatives to patients at risk of AKI.

 

We gained an understanding of the role of medicine management pharmacists play in implementing kidney health quality improvement initiatives.

 

The following resources form a key part of this project:

 

• Credit-card sized sick day guidance card
   
• A3 patient information poster
   
• A4 information sheet for healthcare workers
   
• A4 shorter briefing sheet for healthcare workers.

 

Who did we work with?

NHS Salford CCG

Salford Royal NHS Foundation Trust

 

Downloadable resources

 

• Evaluation Reports

  We produced a report and an executive summary for NHS Salford CCG to inform future care and research. A paper has since been published from this work. A detailed case study on this project is also featured on the Think Kidneys website.

   

  Sick Day Guidance Card

• Publications

  Martindale AM, Elvey R, Howard S, McCorkindale S, Sinha S & Blakeman T., (2017). Understanding the implementation of ‘sick day guidance’ to prevent Acute Kidney Injury across a primary care setting in England: a qualitative evaluation. BMJ Open Vol.7(11)

   

  Blakeman T, Griffith K, Lasserson D, Lopez B, Tsang JY, Campbell S & Tomson C., (2016). Development of guidance on the timeliness in response to acute kidney injury warning stage test results for adults in primary care: an appropriateness ratings evaluation. BMJ Open Vol.6(10) 

   

  Morris R, Ashcroft D, Phipps D, Bower P, O’Donoghue D, Roderick P, Harding S, Lewington A & Blakeman T., (2016). Preventing acute kidney injury: a qualitative study exploring ‘sick day rules’ implementation in primary care. BMC Family Practice (17:91) 

   

  Whiting P, Savovic J, Morden A, Caskey F, Blakeman T, Tomson C, Stone T, Richards A, Savovic J & Horwood J., (2017).  What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury?: A systematic review and meta-analysis. BMJ Open Vol.7(4)

• Presentations

  The importance of acute kidney injury - Various

• Posters

  Preventative interventions for acute kidney injury - Susan Howard

   

  Sick Day Guidance Poster

 

More information

For further information, please contact Susan Howard (Programme Manager) or Tom Blakeman (Principle Investigator)