Hypokalaemia: Improving the investigation, management and therapeutic monitoring of hypokalaemic medical inpatients at a district general hospital
نویسندگان
چکیده
Hypokalaemia is prevalent in 20% of hospitalised patients. Furthermore, inadequate management of hypokalemia was identified in 24% of these patients. Associated with significant patient morbidity and mortality, the identification, investigation, and treatment of hypokalaemia was identified as an area for improvement in the management of medical inpatients. The project aims to measure the assessment, management, and therapeutic monitoring of medical inpatients with hypokalaemia in a district general hospital. All medical inpatients over a one week period who met the criteria for hypokalaemia (serum potassium <3.5 mmol/L on standard biochemical sample) were included in the audit. Patient's notes were located and evaluated to identify if they had mild, moderate, or severe hypokalaemia. Further data on ECG requests, repeat U&Es, serum magnesium analysis, treatment prescribed, and medication review dates was collated. A re-audit was completed after the introduction of a set of interventions which included a hypokalaemia treatment algorithm. Pre-intervention analysis of all medical inpatients, who met our inclusion criteria for hypokalaemia, identified 32 patients. 25 of these patients met the criteria for mild hypokalaemia (3.1-3.4 mmol/L) and 7 met the criteria for moderate hypokalaemia (2.5-3.0 mmol/L). Only 7/32 (22 %) patients were receiving adequate treatment based on trust guidelines. Post intervention results showed marked improvement in the management of patients with hypokalaemia. A total of 30 patients were identified in this post-intervention group. There were 16/30 patients who qualified as mild hypokalaemia (3.1-3.4 mmol/L) and 14/30 with moderate hypokalaemia (2.5-3.0 mmol/L). 19/30 (63%) patients in the post-intervention group were correctly prescribed appropriate medication doses consistent with the treatment algorithm. Following the initial success of the project, analysis at 3 months showed a positive trend for sustained improvement when compared to the pre-intervention results.
منابع مشابه
Hypokalaemia: common things occur commonly – a retrospective survey
OBJECTIVES To define the causes of hypokalaemia in an unselected adult population. DESIGN Retrospective survey of biochemistry database. SETTING District general hospital in southwest Scotland. PARTICIPANTS AND MAIN OUTCOME MEASURES There were 187,704 measurements of urea and electrolytes in 2010. Sixty-one patients had serum potassium <2.5 mmol/L on at least one occasion. RESULTS Avera...
متن کاملHypokalaemia and ventricular fibrillation in acute myocardial infarction.
Serum potassium concentrations obtained on admission to hospital were inversely related to the incidence of ventricular fibrillation in 289 women and 785 men with acute myocardial infarction, 92 of whom developed ventricular fibrillation. Hypokalaemia (serum potassium concentration less than or equal to 3.5 mmol/l) was found in 122 patients (11.4%). The incidence of ventricular fibrillation was...
متن کاملA man with a worrying potassium deficiency
UNLABELLED Hypokalaemia may present as muscle cramps and Cardiac arrhythmias. This is a condition commonly encountered by endocrinologists and general physicians alike. Herein, we report the case of a 43-year-old gentleman admitted with hypokalaemia, who following subsequent investigations was found to have Gitelman's syndrome (GS). This rare, inherited, autosomal recessive renal tubular disord...
متن کاملSelf-Assessment of Medical Interns on Their Ability to Management of Inpatients in the Internal Department at Shahid Sadoughi University of Medical Sciences
Introduction: Knowledge of medical students is usually assessed by exams, but it is not related to their sense of readiness. Self-assessment is one of the methods for measuring medical professional readiness that has been less considered in medical education. This study aimed to determine the degree of acquisition of professional skills of medical interns in the management of inpatients through...
متن کاملعوامل موثر بر رضایتمندی بیماران بستری در بیمارستانهای دانشگاه علوم پزشکی تهران
Background and Aim: With growing emphasis on cost containment, optimal use of resources and increased productivity, the health sector is now adopting an increasingly customer-oriented approach within its administrative and managerial structure. One way to assess hospital performance and service quality would be to measure the level of satisfaction in hospital inpatients, as this group comprises...
متن کامل