This is a Quality Improvement Project for an undergraduate Adult Nursing BSc course in the UK. It is my final year. The aim of this project is to suggest ways to improve nursing practice in an area we have identified while out in our practical placements. While on placement, I was in an oncology hospital and participated in gathering information for an audit (which they never concluded so I cannot formaly utilise their audit) so we realis there is high incidence of AKI in oncology patients due to various factors, i.e. medication, dehydration, chemotherapy and other treatments. Moreover, that despite new Renal Association guidelines on managing and treating AKI, nurses and other healthcare rofessionals in the oncology sector have failed to identify and promptly manage when AKI happens. So, the puprose of this project would be to suggest changes in practice to improve that. The title therefore, could potentially be "Nursing Interventions as ways to prevent the increase of AKI in oncology patients", but I would welcome any suggestions around this, as I think it is perhaps too extensive for a title. So, in a very summarised manner, this AKI should: (a) Identify a local problem: increase of AKI incidence in oncology patients; (b) discuss how wide this problem is, (c) look t ways to decrease/manage this problem in this group (what are the contributory factors, how to mitigate, are there any guidelines and if so, why are people not following it? Is there another possible way of communicating these guidelines efficiently in practice?), and (d) propose ideas for change (i.e. for nursing staff, medical, pharmacy, etc) (i.e. Care bundle for nurses and healthcare practitioners as record of practice). Ideally, every student should have an audit to base their QIP on, however, I do nt have one as it was not finalised. But my lecturer mentioned this was not a problem, but I should still mention there was no audit available in the area where I was, look at the subject area from UK perspective only, find evidence that it is an issue in the UK (i.e Policies, guidelines, audits, NICE, Associations (i.e. renal association uK), NHS Trusts, research evidence). My suggestion for improvement for this project should be Implementation of a Care Bundle with Training. I can provide you with examples so you can put this together. Below is a link to my file on onedrive with some documents I have put together and listed below: Link will be provided, please request. 1. University Guidelines and Rubric (please read these two documents VERY CAREFULLY as they tell you exactly what and how they expect this assignment to be written. Please aim to 79 and above for the rubric grade). These documents will give you the word count (4000), APA 6th edition style reference, and many other details for the specifics of this assignment. number of references, can be more than 12 or less if you think is best… 2. Lecturs and Templates – these will give you an idea on what they want to see. All tables you will need to produce as result of your research on the platforms like CHINAHL, PubMed, etc and analysis. All tables are provided in these documents, you will have to choose the most appropriate as you write the project and modify the figures according to your findings and analysis. The only table you will need to produce yourself, will be the Acute Kidney injury (AKI) Bundle – but I will also give you an example, you just have create this document on word format and use it as an appendix – and I think you will have to also discuss how this table will haelp you achieve the goal of the project. The training part I will also provide you with a template for poster and guideline outline which you can use as a guide to create your own. 3. QI Examples – these are some examples the university provided us with so we could have an idea of what they expect. 4. QI Research – some information I found online while reseraching, but please only consider pepers from UK. 5. Templates and Drafts – just something i was working on while doing some preparation to write this in the beginning of the year. But it never went forward. 6. RMH Precedents: AKI Guidelines from an NHS trust which you can use as tool to outline what points should be included on training of staff (i.e. AKI training poster, hospital guidelines and AKI care bundle). In the link above you will find all documents I could think of to give you as much information as possible, but i have also uploaded some pictures of what I mentioned as: (a) AKI Care Bundle to be designed, (b) AKI training poster for staff and (c) a screenshot of what failed in the audit information I collected (i.e. we analysed 66 patients of AKI from May 2020 to December 2021. only 41 patients had their fluid balance started within 6 hours of diagnosed with AKI, only 8 had urineanalysis done within 12 hours after AKI was diagnosed, only 36 had IV fluids increased/initiated from moment of diagnosis, only 28 VBG were completed, only 26 biochemistry blood tests were completed and only 5 had their daily weights recorded. These factors are so important and directly related to AKI management, so this is actually great failure and some of these patients died within 3 months after being diagnosed with AKI. Please do let me know if there is anything else you need from me.
