Exploring CRRT practices in ICU: A survey of Canadian hospitals

Continuous renal replacement therapy (CRRT) is a highly specialized therapy not only for patients with acute renal failure, but also for patients with other critical conditions. The nursing work involved in CRRT is complex and the learning requirements are challenging to sustain ongoing competence. There are also adverse events associated with CRRT, such as those resulting from the anticoagulation therapy. Limited nursing literature is available regarding the use of CRRT by nurses in Canadian intensive care units. In 2005, the authors conducted a national survey of CRRT nursing practices with nurse educators in intensive care units. The survey had fixed choice, as well as open-ended questions exploring various aspects of CRRT implementation, including education provided and adverse events experienced by patients. Of the 53 teaching and non-teaching hospitals that were sent the survey, 50 replied (94% response rate). Thirty-four of the sites used CRRT. The results reported here represent the findings from the survey questions pertaining to education and adverse events only. The results indicate that education, continuing competence, and prevention and management of adverse events, such as bleeding and filter clotting, are the major issues related to CRRT nursing practice across Canada.