S KOTWAL1,2, G TALAULIKAR3, N GRAY4, K POLKINGHORNE5, S MCDONALD6, A CASS7, M GALLAGHER1,8
1The George Institute for Global Health, University of NSW, Sydney, NSW; 2Prince of Wales Hospital, Sydney, NSW; 3Renal Services, ACT Health, Canberra, ACT; 4Sunshine Coast University Hospital, Birtinya, Queensland; 5Monash Medical Centre, Melbourne, Victoria; 6ANZDATA Registry, Adelaide, South Australia; 7Menzies School of Health Research, Darwin, Northern Territory; 8Concord Clinical School, University of Sydney, NSW
Aim: This project aims to standardise data collection related to catheter complications, benchmark renal unit performance and provide real-time reporting.
Background: Patients with kidney disease are susceptible to healthcare associated infections, especially in association with central venous dialysis catheter use. These catheters are a major driver of blood stream infection and the increased mortality seen in dialysis patients.
Haemodialysis catheter care has been managed by individual renal units, without real-time reporting and limited national benchmarking. We currently lack the necessary tools to analyse clinical variation and mount an effective timely response. Data on the true extent of catheter use and outcomes is limited and unreliable.
Methods: The project has developed standardised definitions around dialysis catheter usage and complications, validated for accuracy by a central committee. Development of a custom-designed data collection tool used by clinical staff has enabled real-time data collection and reporting.
The data collection tool was designed and developed using an iterative consultative process with participating renal units. Regular feedback meetings have been conducted since the launch of the data collection tool with changes/updates made using the feedback.
Results: The first phase of this study has involved the design, implementation and uptake of the data collection tool.
Of the 36 units involved in the study, 25 are currently entering data. We have data on 563 participants, 353 active catheters with 25,247 total catheter days. We expect data on approximately 9000 participants by the end of the study in 2020.
Conclusions: Early involvement of renal units, with regular feedback sessions, is invaluable when pursuing an implementation project at this scale. Meaningful representation with effective engagement from each state is essential to implement change nationally.