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Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views

BACKGROUND: Recent studies suggest discrepancies between patients and providers around perceptions of hemodialysis prognosis. Such data are lacking for continuous renal replacement therapy (CRRT). We aim to assess patient and provider understanding of outcomes around CRRT. METHODS: From February 1 t...

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Autores principales: Allegretti, Andrew S., Hundemer, Gregory, Chorghade, Rajeev, Cosgrove, Katherine, Bajwa, Ednan, Bhan, Ishir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501124/
https://www.ncbi.nlm.nih.gov/pubmed/26169052
http://dx.doi.org/10.1186/s12882-015-0086-5
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author Allegretti, Andrew S.
Hundemer, Gregory
Chorghade, Rajeev
Cosgrove, Katherine
Bajwa, Ednan
Bhan, Ishir
author_facet Allegretti, Andrew S.
Hundemer, Gregory
Chorghade, Rajeev
Cosgrove, Katherine
Bajwa, Ednan
Bhan, Ishir
author_sort Allegretti, Andrew S.
collection PubMed
description BACKGROUND: Recent studies suggest discrepancies between patients and providers around perceptions of hemodialysis prognosis. Such data are lacking for continuous renal replacement therapy (CRRT). We aim to assess patient and provider understanding of outcomes around CRRT. METHODS: From February 1 to August 31, 2013, a triad of (1) a patient on CRRT (or health care proxy [HCP]), (2) physician and (3) primary nurse from the intensive care unit (ICU) team were surveyed. Univariate chi-square and qualitative analysis techniques were used. RESULTS: Ninety-six total participants (32 survey triads) were completed. Ninety one percent of patients/HCPs correctly identified that CRRT replaced the function of the kidneys. Six percent of patients/HCPs, 44 % of physicians, and 44 % of nurses identified rates of survival to hospital discharge that were consistent with published literature. Both physicians and nurses were more likely than patients/HCPs to assess survival consistently with published data (p = 0.001). Patients/HCPs were more likely to overestimate survival rates than physicians and nurses (p < 0.001). Thirty eight percent of patients/HCPs, 38 % of physicians, and 28 % of nurses identified rates of lifelong dialysis-dependence among surviving patients that were consistent with published literature. CONCLUSIONS: There is mismatch between patients, HCPs, and providers around prognosis of CRRT. Patients/HCPs are more likely to overestimate chances of survival than physicians or nurses. Further intervention is needed to improve this knowledge gap. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-015-0086-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-45011242015-07-15 Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views Allegretti, Andrew S. Hundemer, Gregory Chorghade, Rajeev Cosgrove, Katherine Bajwa, Ednan Bhan, Ishir BMC Nephrol Research Article BACKGROUND: Recent studies suggest discrepancies between patients and providers around perceptions of hemodialysis prognosis. Such data are lacking for continuous renal replacement therapy (CRRT). We aim to assess patient and provider understanding of outcomes around CRRT. METHODS: From February 1 to August 31, 2013, a triad of (1) a patient on CRRT (or health care proxy [HCP]), (2) physician and (3) primary nurse from the intensive care unit (ICU) team were surveyed. Univariate chi-square and qualitative analysis techniques were used. RESULTS: Ninety-six total participants (32 survey triads) were completed. Ninety one percent of patients/HCPs correctly identified that CRRT replaced the function of the kidneys. Six percent of patients/HCPs, 44 % of physicians, and 44 % of nurses identified rates of survival to hospital discharge that were consistent with published literature. Both physicians and nurses were more likely than patients/HCPs to assess survival consistently with published data (p = 0.001). Patients/HCPs were more likely to overestimate survival rates than physicians and nurses (p < 0.001). Thirty eight percent of patients/HCPs, 38 % of physicians, and 28 % of nurses identified rates of lifelong dialysis-dependence among surviving patients that were consistent with published literature. CONCLUSIONS: There is mismatch between patients, HCPs, and providers around prognosis of CRRT. Patients/HCPs are more likely to overestimate chances of survival than physicians or nurses. Further intervention is needed to improve this knowledge gap. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-015-0086-5) contains supplementary material, which is available to authorized users. BioMed Central 2015-07-14 /pmc/articles/PMC4501124/ /pubmed/26169052 http://dx.doi.org/10.1186/s12882-015-0086-5 Text en © Allegretti et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Allegretti, Andrew S.
Hundemer, Gregory
Chorghade, Rajeev
Cosgrove, Katherine
Bajwa, Ednan
Bhan, Ishir
Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
title Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
title_full Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
title_fullStr Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
title_full_unstemmed Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
title_short Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
title_sort perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501124/
https://www.ncbi.nlm.nih.gov/pubmed/26169052
http://dx.doi.org/10.1186/s12882-015-0086-5
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