Acceptance of Acute Kidney Injury Alert by Providers in Cardiac Surgery Intensive Care Unit.

BACKGROUND: Acute Kidney Injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Its management relies on early diagnosis, and therefore, electronic alerts have been used to alert clinicians for development of AKI. Electronic alerts are, however, associated with high rates of alert fatigue.

OBJECTIVES: We designed this study to assess the acceptance of user-centered electronic AKI alert by clinicians.

METHODS: We developed a user-centered electronic AKI alert, that provided alerted clinicians of development of AKI in a persistent yet non-interruptive fashion. As the goal of the alert was to alert towards new or worsening AKI, it disappeared 48 hours after being activated. We assessed the acceptance of the alert using surveys at 6 months and 12 months after the alert went live.

RESULTS: At 6 months after their implementation 38.9% providers reported that they would not have recognized AKI as early as they did without this alert. This number increased to 66.7% by 12 month survey. Most providers also shared that they re-dosed or discontinued medications earlier, provided earlier management of volume status, avoided IV contrast use and evaluated patients by using point of care ultrasounds more due to the alert. Overall, 83.3% respondents reported satisfaction with the electronic AKI alerts at 6 months and 94.4% at 12 months.

CONCLUSIONS: This study showed high rates of acceptance of a user-centered electronic AKI alert over time by clinicians taking of patients with AKI.