• Peggy Lambert, Kristine Chaisson, Susan Horton, Carmen Petrin, Emily Marshall, Sue Bowden, Lynn Scott, Sheila Conley, Janette Stender, Gertrude Kent, Ellen Hopkins, Brian Smith, Anita Nicholson, Nancy Roy, Brenda Homsted, Cindy Downs, Cathy S Ross, Jeremiah Brown, and Northern New England Cardiovascular Disease Study Group.
• Peggy Lambert is executive director of critical care services, Sue Bowden is a nurse, and Carmen Petrin and Lynn Scott are nurse practitioners at Catholic Medical Center, Manchester, New Hampshire.
• Crit Care Nurse. 2017 Feb 1; 37 (1): 132613-26.

BackgroundAcute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year.ObjectiveTo reduce acute kidney injury due to contrast material after cardiovascular interventional procedures.MethodsNurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions.ResultsCompared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material.ConclusionsStandardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.©2017 American Association of Critical-Care Nurses.

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