Colleene Young RN, BSN, CCRN PICU Clinical Nurse IV Childrens Hospital Los Angeles
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Nurse Responsibilities & Clinical Decision Making When Caring for Critically Ill Pediatric Patients Requiring Continuous Renal Replacement Therapy Colleene Young RN, BSN, CCRN PICU Clinical Nurse IV Childrens Hospital Los Angeles
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Nurse Responsibilities & Clinical Decision Making When Caring for Critically Ill Pediatric Patients Requiring Continuous Renal Replacement Therapy. Colleene Young RN, BSN, CCRN PICU Clinical Nurse IV Childrens Hospital Los Angeles. Childrens Hospital Los Angeles. - PowerPoint PPT Presentation
Transcript of Colleene Young RN, BSN, CCRN PICU Clinical Nurse IV Childrens Hospital Los Angeles
Nurse Responsibilities & Clinical Decision Making When Caring for
Critically Ill Pediatric Patients Requiring Continuous Renal
Replacement Therapy
Colleene Young RN, BSN, CCRNPICU Clinical Nurse IV
Childrens Hospital Los Angeles
Childrens Hospital Los Angeles 286-Bed tertiary care children’s hospital
Affiliated with University Southern California Keck School of Medicine (20 bed PICU; 15 bed CTICU; 40 bed NICU)
Hospital admissions annually >11,000
PICU admissions annually >1,100
Training, Competencies & Troubleshooting
• Training includes one day class & two precepted shifts
• All critical care fellows are required to attend hemofiltration class
• Annual skills lab; nurses & fellows attend
• Circuit changes & troubleshooting measures tracked
Patients/year, Length of Stay & Survival
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5
10
15
20
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40
2005 2006 2007 2008 2009
# Patients/yr
Median LOS
# Survived
• Nurses present in rounds, actively participates in plan of care
•Worksheet computes 24º total intake (infusions, meds & flushes)
• Net (-/+) fluid balance determined; hemoflitration flow rates adjusted
Childrens Hospital Los Angeles Hemofiltration Order Sheets
Hemofiltration
infusions, settings,
volumes & net hourly
fluid balance are
documented in the
electronic patient
record
ECMO trained nurses are required to maintain
competency to manage hemofiltration pump
PICU nurses also manage
CTICU hemofiltration
Hemofiltration used commonly as adjunct therapy with ECMO
• Your Text here
• Hemofiltration may be continued when patients require surgery
• PICU nurses manage hemofiltration intra-operatively
• Study demonstrated benefit of CRRT during orthotopic liver transplantation
• Patients with hepatic disease at risk for acute kidney injury• Maintaining an even or negative fluid balance beneficial
Colleene Young RN, BSN, CCRNPICU Clinical Nurse IV
Childrens Hospital Los AngelesPediatric Intensive Care Unit4650 Sunset Blvd MS # 74
Los Angeles, CA 90027 USA+1 (323) 361-2584
Thank You!
