CRRT documentation education: Increasing compliance on a new electronic health record

Continuous renal replacement therapy (CRRT) is a modality by which critically ill and hemodynamically unstable patients in the intensive care unit (ICU) can receive hemodialysis. Documentation for CRRT includes many crucial elements and contributes significantly towards the achievement of treatment goals. One of these is ultrafiltrate (UF) removal calculation, which is imperative to addressing fluid volume overload and reducing mortality. Our large academic medical center implemented a new electronic health record (EHR) that revamped CRRT documentation and was rife with opportunities for improvement. A hospital-wide survey sent to ICU staff revealed that most nurses felt they did not receive adequate CRRT documentation education, specifically tailored towards the new EHR. Review of the literature supported the notion that improvements in documentation could be made through enhanced educational offerings. The CRRT nursing curriculum was redesigned to place more emphasis on teaching the purpose and correct implementation of documenting in our EHR. The results of the educational intervention were increased confidence in CRRT documentation as well as improved competency.