Knowledge deficiency of acute kidney injury management among healthcare professionals: cause for concern?

Abstract

Background: In 2009, an audit into the death of a patient with a diagnosis of acute kidney injury (AKI) revealed several shortcomings in the management of AKI patients in UK hospitals. The National Confidential Enquiry into Patients Outcome and Death (NCEPOD) reports that the poor management of AKI is commonly related to poor clinical care, and it is recommended that all clinical staff receive regular teaching on AKI to improve their knowledge and skills. Aim: This study aimed to establish the level of understanding of healthcare professionals caring for patients with AKI and ways to provide intervention to overcome any deficiencies. Method: This study used a cross-sectional online questionnaire survey. The questionnaire was posted using the Survey Monkey online tool and sent via a link to healthcare professionals. The links allowed respondents to answer the questions and recorded their anonymised responses. The online survey link was sent out via mail to the staff of three Trusts within Cambridgeshire and Hertfordshire region between May and July 2019. Results: A total of 135 people responded to the survey. A total of 34% (n=46) correctly identified the definition of AKI and correct staging of AKI was 31% (42). A higher number of respondents correctly selected risk factors (85%; n=116), assessments (68%; n=92) and observational information (78%; n=105). There was a statistically significant association between AKI teaching and knowledge of AKI definition, staging and assessment. There was no strong association between AKI teaching and the respondent's ability to recognise risk factors or observation carried out on AKI patients. While there was a slight improvement in individual performance scores against AKI teaching, this was not statistically significant. Conclusion: This study identified specific gaps in knowledge of AKI management among healthcare professionals. An educational intervention will be required to increase AKI management awareness, which may in turn improve the clinical outcomes.