This document provides an overview of the Alaska Trauma Registry training. It discusses the different tabs under Potentially Inappropriate (PI), including Filters, ACS Filters, EMS Filters, Alaska-Defined Filters, and Complications. For each set of filters, it provides examples and explains the patient populations to which they apply, and how the filters should be answered. The document demonstrates how to navigate the registry and appropriately apply the various filters to track patient care issues.
Back to the Bedside: Internal Medicine Bedside Ultrasound ProgramAllina Health
David Tierney, MD. How bedside ultrasound is changing the practice of medicine and how Abbott Northwestern Hospital has become a national leader in integrating bedside ultrasound in its Internal Medicine Residency Program. "As internal medicine physicians, we are finding that everything we do with our hands, eyes and stethoscopes can be done a little better with ultrasound. That means our physical exam, which we consider our bread and butter, has more sensitivity and specificity. This gives us better diagnostic ability and results in earlier and more appropriate treatment."
The post operative period begins from the time the patient leaves the operating room and ends with the follow up visit by the surgeon. The post operative care is provided by – PACU
Structured Approach to Critically Ill and Injured Patientmetriccertain
CERTAIN (Checklist for Early Recognition and Treatment of Acute Illness and iNjury) is designed and developed to standardize the approach to the evaluation and treatment of acutely decompensating patients. The design and content was informed by the survey of clinicians from diverse international settings. Available in electronic (laptop/mobile) and paper formats, CERTAIN provides evidence based diagnostic checklists, clinical decision support, educational modules on performing critical procedures, and has the ability to time and document real-time interventions. CERTAIN prompting has been shown to improve performance of clinical providers faced with simulated emergencies.
Back to the Bedside: Internal Medicine Bedside Ultrasound ProgramAllina Health
David Tierney, MD. How bedside ultrasound is changing the practice of medicine and how Abbott Northwestern Hospital has become a national leader in integrating bedside ultrasound in its Internal Medicine Residency Program. "As internal medicine physicians, we are finding that everything we do with our hands, eyes and stethoscopes can be done a little better with ultrasound. That means our physical exam, which we consider our bread and butter, has more sensitivity and specificity. This gives us better diagnostic ability and results in earlier and more appropriate treatment."
The post operative period begins from the time the patient leaves the operating room and ends with the follow up visit by the surgeon. The post operative care is provided by – PACU
Structured Approach to Critically Ill and Injured Patientmetriccertain
CERTAIN (Checklist for Early Recognition and Treatment of Acute Illness and iNjury) is designed and developed to standardize the approach to the evaluation and treatment of acutely decompensating patients. The design and content was informed by the survey of clinicians from diverse international settings. Available in electronic (laptop/mobile) and paper formats, CERTAIN provides evidence based diagnostic checklists, clinical decision support, educational modules on performing critical procedures, and has the ability to time and document real-time interventions. CERTAIN prompting has been shown to improve performance of clinical providers faced with simulated emergencies.
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
Review the results of the National SSI audit 2016
Discuss lessons learned from the audit – strengths and areas for improvement
Gather ideas for future steps for prevention of SSI
WATCH: http://goo.gl/i5wVSy
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
Review the results of the National SSI audit 2016
Discuss lessons learned from the audit – strengths and areas for improvement
Gather ideas for future steps for prevention of SSI
WATCH: http://goo.gl/i5wVSy
Avoiding errors in diagnosing abdominal painDr Varun Patel
Diagnosing Abdominal pain is Emergency department is a tough task. This presentation covers all possible causes of Abdominal pain. As an Emergency Physician you need to look through all these causes of Abdominal Pain in order to not miss a diagnosis.
In working within the parameters of the SaferHealth Care Now bundle what have we within Sunrise been able to do to increase patients safety. By looking at indicators of infection we have been able to set up improvement projects to work towards a goal of zero clean surgical site infections. This session is to describe three of these improvement projects.
Dr. Kenneth Dickie from Royal Centre of Plastic Surgery in Barrie, Ontario explained the refining experience for Ambulatory Surgery.
If you have any questions, please contact Dr. Kenneth Dickie at http://royalcentreofplasticsurgery.com/
Surgery Resident clinical seminar on day case surgery presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
7. PI: Filters
• ACS Filters – Mandatory
• Was there at least hourly documentation and recording of vitals?
• Was there at least hourly determination of GCS for any trauma patient while in the ED with skull
fracture and GCS < 12 or spinal cord injury?
• Did patient require reintubation of airway within 48 hours of extubation?
• Was abdominal, thoracic, vascular or cranial surgery performed more than 24 hours after arrival?
• Was burn patient with an inhalation injury not intubated?
• Did burn patient have an initial escharotomy performed more than 8 hours after arrival?
• Did this patient have an unplanned return to the operating room?
• Was this an unplanned visit for the same injury for which patient was seen in the facility’s ED and
discharge home within the last 72 hours?
• Was the patient’s cervical spine injury/fracture identified in the ED?
• Did this patient require reintubation > 24 hours after extubation?
8. PI: Filters
• ACS Filters Additional Information
• Apply to care at your facility
• Each PI filter applies to specific patient population (a subset of all the trauma
patients)
• These are not simple yes and no questions; the Field Value may have a
different definition for each PI Filter
• Have your Data Dictionary with you until you know these ACS filters
• Full definition of each filter is in the Data Dictionary
• Any “unknown” responses will not fall out for review on Standard ACS
Filter Report
9. PI: ACS Filters
• Was there at least hourly documentation and recording of vitals?
• Patient Population
• Emergency department patients who are unstable or critical
• Critical patients are those that are a critical care admission, transfers or deaths
• Trauma Activation for “prehospital unstable”, “ED unstable” or “potentially unstable”
• If patient determined to be stable, the hourly vital signs may no longer apply,
and filter can still be a “yes”
• This would be a facility criterion
• Applies to ED documentation only (including time in radiology or special
procedure lab)
• Answer
• Yes - Vitals obtained hourly
• No - Vitals not obtained hourly
• NA - Not treated in the emergency department
10. PI: ACS Filters
• Was there at least hourly determination of GCS for any trauma patient while in
the ED with skull fracture and GCS < 12 or spinal cord injury?
• Patient Population
• Only applies to patients with a skull fracture with a Glasgow Coma scale < 12;
or has a spinal cord injury (regardless of GCS)
• GCS or neurological checks may meet filter intent
• Applies to ED documentation only (including time in radiology or special
procedure lab)
• Answer:
• Yes - GCS (or neurological checks) obtained hourly
• No - GCS (or neurological checks) not obtained hourly
• NA - Not Treated in ED or does not have Skull Fracture with GCS of <12, or
spinal cord injury
11. PI: ACS Filters
• Did patient require reintubation of airway within 48 hours of extubation?
• Patient Population
• Applies to all patients that are extubated at your facility
• Answer:
• Yes - Required reintubation within 48 hours of extubation
• No - Did not require reintubation within 48 hours of extubation, or
Electively reintubated for surgical or diagnostic procedure, or
Reintubation occurring greater than 48 hours after extubation
• NA - Not intubation or not extubated
12. PI: ACS Filters
• Was abdominal, thoracic, vascular or cranial surgery performed more
than 24 hours after arrival?
• Patient Population
• Applies to patients who have an unanticipated operation more than 24 hours
after patient arrival in ED
• May enter up to 4 selections
• Abdominal Unanticipated abdominal operation performed
• Thoracic Unanticipated thoracic operation performed
• Vascular Unanticipated vascular operation performed
• Cranial Unanticipated cranial operation performed
• Review physician H&P, op notes, progress notes to determine if surgery was
planned/anticipated
13. PI: ACS Filters
• Was burn patient with an inhalation injury not intubated?
• Patient Population
• Applies to all trauma burn patients
• Inhalation injury
• Damage to the pulmonary parenchyma caused by inhalation of substances
• Very hot air
• Toxic gas
• Asbestos
• Chemical products
• Answer:
• Yes - Has inhalation injury but NOT intubated
• No - Has inhalation injury and WAS intubated
• NA - Did not have inhalation injury
14. PI: ACS Filters
• Did burn patient have an initial escharotomy performed more than 8
hours after arrival?
• Patient Population
• Applies to all trauma burn patients
• Answer:
• Yes - Had escharotomy performed more than 8 hours after arrival
• No - Had escharotomy performed less than 8 hours after arrival
• NA - Did not have escharotomy performed
15. PI: ACS Filters
• Did this patient have an unplanned return to the operating room?
• Patient Population
• Applies to all trauma patients
• Answer:
• Yes - Unplanned return to operating room
• No - Returned to operating room but planned, or went to surgery only once
• NA - Never went to operating room
16. PI: ACS Filters
• Was this an unplanned visit for the same injury for which patient was seen in the
facility’s ED and discharge home within the last 72 hours?
• Patient Population
• Applies to the patients treated in your ED and returns to your facility for previously
unplanned admission (thru ED or DA) within 72 hours of the previous ED visit for
the same injury.
• Answer:
• Yes - Patient seen for this injury and discharged home from your ED and returns for
admission within 72 hours of an ED visit at your facility
• No - Patient seen for this injury and either left AMA or was transferred to another
facility and returns for admission within 72 hours of an ED visit to your facility
• NA - Patient not seen for this injury in your ED within the last 72 hours; patient does
not meet patient population
17. PI: ACS Filters
• Was the patient’s cervical spine injury/fracture identified in the ED?
• Patient Population
• Applies to all patients with a final diagnosis of cervical spine (cord) injury
and/or fracture
• Answer:
• Yes - Cervical spine injury/fracture was identified in the ED
• No – Cervical spine injury/fracture NOT identified in the ED
• NA - The patient did not have a cervical spine injury/fracture
18. PI: ACS Filters
• Did this patient require reintubation > 24 hours after extubation?
• Patient Population
• Applies to all patients that are extubated at your facility
• Answer:
• Yes – Required reintubation greater than 24 hours after extubation
• No – Did not require reintubation greater than 24 hours after extubation, or
Electively reintubated for surgical or diagnostic procedure, or Reintubation
occurring in less than 24 hours after extubation
• NA - Not intubation or not extubated
22. PI: Filters
• EMS Filters
• Unstable patient on scene greater than 10 minutes?
• EMS activated trauma alert on unstable prehospital patients?
• EMS activated trauma alert on patient with ISS greater than 15?
• Was tourniquet applied prehospital?
• Was cervical spine immobilization applied in ED?
• EMS administered oxygen to patient when O2 saturation less than 94 percent?
• Definitive airway applied prehospital?
• Definitive airway applied in ED?
23. PI: EMS Filters
• EMS Filters Additional Information
• Applied to prehospital EMS agency delivering patient to your facility
• Skipped if no prehospital EMS agency
• Skipped if a Transfer In
• If does not auto-fill manually then answer
• Can’t auto-fill with yes and no
• Place curser over filter box to see if it is open for data entry
• Full definition in Alaska Data Dictionary
24. PI: EMS Filters
• Unstable patient on scene greater than 10 minutes?
• Patient Population
• Applies to prehospital unstable patients
• Auto-fills with Yes if Prehospital Departs Location minus Prehospital
Arrived at Patient is greater than 10 minutes
• Field opens for Patient Status: 1, Prehospital Unstable and not a Transfer In.
• Blank if either Prehospital Arrival at Patient or Prehospital Departs Location are
unknown.
• Answer:
• Yes – Scene time > 10 minutes
• No – Scene time < 10 minutes
• NA - Not an unstable patient or not transported by EMS
25. PI: EMS Filters
• EMS activated trauma alert on unstable prehospital patients?
• Patient Population
• Prehospital unstable patients transport by EMS
• Auto-fills with Yes if Trauma Alert Called by EMS date/time entered for a Prehospital
Unstable patient
• Field opens for Patient Status: 1, Prehospital Unstable and not a Transfer In.
• Blank if either Patient Status or Trauma Alert Called by EMS date/time are unknown.
• Answer:
• Yes – Prehospital EMS DID activate (notify) hospital for unstable prehospital patient
• No – Prehospital EMS DID NOT activate (notify) hospital for unstable
prehospital patient
• NA - Not an unstable prehospital EMS trauma patient
26. PI: EMS Filters
• EMS activated trauma alert on patient with ISS greater than 15?
• Patient Population
• Trauma patients with ISS >15 transported by prehospital EMS
• Auto-fills with yes if Trauma Alert Called in by EMS date/time entered for a trauma
patient with ISS greater than 15
• Field open for prehospital EMS transport patient with ISS > 15 and not a Transfer In
• Answer:
• Yes – Prehospital EMS DID activate (notify) hospital for trauma patient with ISS > 15
• No – Prehospital EMS DID NOT activate (notify) hospital for trauma patient with ISS
> 15
• NA - Not a trauma patient with ISS > 15
27. PI: EMS Filters
• Was tourniquet applied prehospital?
• Patient Population
• All trauma patients transported by EMS
• Auto-fills with yes if Prehospital Treatment “tourniquet” checked off
• Field opens for patient transported prehospital by EMS and not a Transfer In
• Blank if Prehospital Treatment “tourniquet” NOT checked off.
• Answer:
• Yes – Prehospital EMS applied tourniquet prehospital
• No – Prehospital EMS DID NOT apply a tourniquet prehospital
• NA - Not transported by prehospital EMS
28. PI: EMS Filters
• Was cervical spine immobilization applied in ED?
• Patient Population
• All trauma patients transported by EMS
• Auto-fills with Yes if prehospital transfer and ED applied cervical collar
• Field opens for patient transported prehospital by EMS and not a Transfer In
• Blank if Prehospital Treatment “cervical immobilization” checked off
• Answer:
• Yes – ED applied cervical spine immobilization
• No – ED did not apply cervical spine immobilization or EMS had applied
cervical spine immobilization
• NA - Not transported by prehospital EMS
29. PI: EMS Filters
• EMS administered oxygen to patient when O2 saturation less than 94 percent?
• Patient Population
• All trauma patients transported by EMS
• Auto-fills with Yes if Prehospital Treatment “oxygen” checked off and prehospital
Oxygen Saturation is < 94%.
• Field opens for patient transported prehospital by EMS, prehospital O2 Saturation <
94%
• Blank if Prehospital Treatment “oxygen” NOT checked off and Prehospital
O2Saturation < 94%
• Answer:
• Yes – Oxygen administered by EMS for patient is oxygen saturation < 94%.
• No – Oxygen not administered by EMS for patient is oxygen saturation < 94%
• NA - Trauma patient oxygen saturation > 94% or not transported by EMS
30. PI: EMS Filters
• Definitive airway applied prehospital?
• Patient Population
• All trauma patients transported by EMS
• Auto-fills with Yes if one of the following Prehospital Treatments “intubation, EOA,
LMA or cricothyroidotomy” checked off
• Field opens for data entry for patient transported prehospital by EMS and not a Transfer
In
• Blank if one of the following Prehospital Treatments “intubation, EOA, LMA or
cricothyroidotomy” NOT checked off
• Answer:
• Yes – EMS placed definitive airway prehospital
• No – EMS DID NOT place definitive airway prehospital
• NA - Not transported by prehospital EMS
31. PI: EMS Filters
• Definitive airway applied in ED?
• Patient Population
• All trauma patients transported by EMS
• Auto-fills with Yes if an ICD-10-PCS code is entered for a definitive airway on
Procedure screen with Location of ED.
• Field opens for patient transported prehospital by EMS and not a Transfer In.
• Blank if Prehospital EMS transport trauma patient and NO ICD-10-PCS code
entered for a definitive airway listed on Procedure screen with Location of ED
• Answer:
• Yes – ED placed definitive airway
• No – ED DID NOT place definitive airway
• NA - Not transported by prehospital EMS
35. PI: Filters
• Alaska Defined Filters
• Tools to track patient care issues at your facility
• Work with your Trauma Committee to select which to monitor
• Determine time period to monitor
• Do not monitor them all – unless decided by committee
• Facility to determine definition for these filters
• Data Dictionary has suggested the definition
• When Tracking a Filter:
• Filter MUST be answered for every patient that meets the defined patient population
• If you have a patient that does not meet the patient population then you can select
NA
• Filters cover all phases of care (e.g., EMS, ED, radiology, inpatient)
36. PI: Alaska-Defined Filters
• EMS adequately splinted extremity fracture
• ED Trauma Team activated per protocol
• ED measure O2 saturation measured upon admission
• ED administered oxygen to patient with O2 < 94 percent
• ED started IV in less than 4 attempts
• ED appropriately splinted extremity fracture
• ED successfully Intubated in less than 4 attempts
• ED reduced dislocated joint reduced prior to transfer or admission
• ED inserted chest tube for pneumothorax (> 25 prior to transfer or admission
37. PI: Alaska-Defined Filters
• ED applied circumferential pelvic compression for complex pelvic fracture prior to
transfer or admission
• ED obtained fetal heart tones for pregnant patient
• ED initiated fetal monitoring for pregnant patient
• ED weighed pediatric patient
• Hypothermic patient (T < 90 F) actively warmed
• Open fracture treated with IV antibiotic in 3 hours of patient’s arrival
• Moderate/deep sedated patient did NOT require assisted respirations or reversal agent
• Cat scan started within 1 hour of being ordered
• Radiology readings free of discrepancies
38. PI: Alaska-Defined Filters
• Radiology services available within 30 minutes of patient’s arrival
• Screening, Brief Intervention and Referral to Treatment (SBIRT) completed
• General surgeon consulted on trauma patient admitted to medicine service
• EMS adequately splinted extremity fracture
• Pediatric patient (<15) intubated with 1 attempt
• Pediatric patient (< 15) extubated within 24 hours of rapid sequence intubation
(excluding operative procedure)
• Pediatric patient (< 15) was appropriately ventilated during the first 12 hours
for a child with normal initial vital signs
• Pediatric patient (<15) received appropriate fluid resuscitation during the first
12 hours for a child with normal initial vital signs
39. PI: Alaska-Defined Filters
• Laparotomy was therapeutic
• Antiplatelet medication administered
• Antiplatelet reversal medication administered
• Sequential compressions devices (SCDs) initiated
• TBI monitoring equipment (Licox, Ventriculostomy drain, etc.) utilized for TBI
• Patients < 15: Imaging guidelines for head injury were followed (PECARN guidelines
• Patients <= 2 injured in home received a non-accidental trauma evaluation
• Patients <= 2 Patient’s temperature was less than 35 C for greater than 2 hours
• Patients <= 15: Fluid administration of >50 ml/kg crystalloid in the first 2 hours
40. PI: Alaska-Defined Filters
• Suggested Patient Population
Cat scan started within 1 hour of being ordered
Suggested Patient Population: All pregnant trauma patients
Yes Cat scan started within 1 hour of being ordered
No Cat scan started > 1 hour of being ordered
44. PI: Alaska-Defined Filters
• Complications
• Complications that occur during hospital stay
• Alaska Data Dictionary includes definition
• NTDB Complications
• NTDB definition
• Changes each year
• Complication = hospital event
• System Filters (Complications)
45. PI: NTDB Complications
• Acute Kidney Injury
• Acute Respiratory Distress Syndrome
• Alcohol Withdrawal Syndrome
• Cardiac Arrest with CPR
• Catheter-Associated Urinary Tract Infection
• Central Line-Associated Bloodstream Infection
• Deep Surgical Site Infection
• Deep Vein Thrombosis
• Delirium
• Extremity Compartment Syndrome
• Myocardial Infarction
46. PI: NTDB Complications
• Organ/Space Surgical Site Infection
• Osteomyelitis
• Pulmonary Embolism
• Pressure Ulcer
• Severe Sepsis
• Stroke/CVA
• Superficial Incisional Surgical Site Infection
• Unplanned Admission to ICU
• Unplanned Intubation
• Unplanned Visit to the Operating Room
• Ventilator-Associated Pneumonia
47. PI: NTDB Complications
• Alaska Data Dictionary Includes
• NTDB Definition
• Additional Information
• Occurred during initial stay at your hospital
• Diagnosis in medical records
• Excluded patients
• Registrar not a nurse
• May need nursing help determine definition meet
• Ask for help
48. PI: NTDB Complications
• Acute Kidney Injury
• Definition
• Acute Kidney Injury, AKI (stage 3), is an abrupt decrease in kidney function.
KDIGO (Stage 3) Table:
• (SCr) 3 times baseline; OR
• Increase in SCr to ≥ 4.0 mg/dl (≥ 353.6 μmol/l) ; OR
• Initiation of renal replacement therapy OR, in patients < 18 years, decrease in eGFR to <35
ml/min per 1.73 m²; OR
• Urine output <0.3 ml/kg/h for > 24 hours; OR
• Anuria for > 12 hours; OR
49. PI: NTDB Complications
• Acute Kidney Injury
• Additional Information
• Must have occurred during the patient's initial stay at your hospital.
• A diagnosis of AKI must be documented in the patient's medical record.
• If the patient or family refuses treatment (e.g., dialysis,) the condition is still
considered to be present if a combination of oliguria and creatinine are present.
• EXCLUDE patients with renal failure that were requiring chronic renal
replacement therapy such as periodic peritoneal dialysis, hemodialysis,
hemofiltration, or hemodiafiltration prior to injury.
• Consistent with the March 2012 Kidney Disease Improving Global Outcome
(KDIGO) Guideline.
50. PI: System Filters (Complications)
• Prehospital – Airway
• Aspiration, Prehospital
• Esophageal Intubation
• Extubation, Unintentional
• Mainstem Intubation
• Unable to Intubate
• Other airway complication
53. PI: System Filters (Complications)
• Complications
• Use Alaska Data Dictionary
• Definitions
• Full list of complications
• Select NTDB complication, checks complication off in system filters
• If mark complication in system filter, checks NTDB complication
57. PI: PI Tracking
• PI Tracking
• Tracking tool available in Web Registry
• Includes all PI steps identified by ACS
• All trauma information stored in one secure location
58. PI: PI Tracking
• Activate PI Tracking
• Quick Review
• High-lite PI filter to be tracked on “Filter” screen
• Select Edit
• Check activate tracking box “yes”
• Close edit box with “ok”
• Go to PI Tracking screen
• Select Auto-trigger filter
• Moves all filters identified for tracking to the PI tracking screen
59.
60.
61. PI: PI Tracking
• PI Tracking
• Tracking tool available in Web Registry
• Includes all PI steps identified by ACS
• All trauma information stored in one secure location
62.
63. PI: PI Tracking
• PI Tracking
• Includes all PI steps identified by ACS
• Issue Identification
• Levels of Review
• Conclusions/evaluation
• Action Plan
• Implementation
• Evaluation / “Loop Closure”
64. PI: PI Tracking
• PI Tracking
• An optional lesson available trauma PI program
• Required components
• How to use the registry
• Step-by-step instruction on the PI Tracking screen
• Report Runner PI reports
• How to track PI
• Case Reviews
• System Review