In response to PAR-14-002 (Advancing Patient Safety Implementation through Safe Medication Use Research), the overall goal of study is disseminate our successful nephrotoxic medication associated acute kidney injury reduction project to other pediatric hospitals. Implementation of our Nephrotoxic Injury Negative by Just-in-time Action (NINJA) project at Cincinnati Children's Hospital resulted in avoidance of nephrotoxic AKI in 130 patients and 900 days of AKI avoided in one year.
Aim 1 will use the Institute for Healthcare Improvement Breakthrough Series Approach to disseminate the project to 9 other children's hospitals.
Aim 2 will measure the impact of NINJA in these hospitals using interrupted time series approaches.
Aim 3 will use qualitative comparative analysis to assess the contextual factors that present barriers or facilitate dissemination of NINJA over the varied support systems present at each institution.

Public Health Relevance

This project will elucidate important contextual information regarding the factors necessary for dissemination of a successful harm reduction project in hospitalized children. We have shown that nephrotoxic medication associated AKI is modifiable and preventable in many cases. The project is relevant to the PA because we 1) focus on communication between pharmacists, nurses and physicians, 2) use health information technology to improve care coordination and 3) empower and incorporate pharmacist providers into interdisciplinary team management. Our ultimate goal is to take the lessons learned from this project to disseminate NINJA through the 78 hospital Solutions for Patient Safety Network.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18HS023763-02
Application #
9042945
Study Section
Healthcare Patient Safety and Quality Improvement Research (HSQR)
Program Officer
Perfetto, Deborah
Project Start
2015-04-01
Project End
2018-03-31
Budget Start
2016-04-01
Budget End
2017-03-31
Support Year
2
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Goldstein, Stuart L (2015) Automated/integrated real-time clinical decision support in acute kidney injury. Curr Opin Crit Care 21:485-9