Assessment of Nurses' Knowledge Regarding Continuous Renal Replacement Therapy
Abstract
Continuous Renal Replacement Therapy (CRRT) is a critical intervention for Acute Kidney Injury (AKI) in intensive care units (ICUs), requiring specialized nursing knowledge. This study assessed nurses' CRRT knowledge levels and explored the impact of demographic factors. A descriptive cross-sectional study was conducted with 46 nurses from two governmental hospitals in Al-Najaf City (March 1–4, 2025). Data were collected via a validated questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) (Version 26), employing descriptive statistics and ANOVA (p ≤ 0.05 significance). Most nurses (80.43%) demonstrated moderate CRRT knowledge (Mean Score (MS) 2.25, Standard Deviation (SD) = 0.58), with only 4.35% exhibiting good knowledge. No significant relationships were found between knowledge and demographic factors (age, sex, education, experience; all p > 0.05). A strong positive correlation existed between knowledge and attitude (r = 0.696, p < 0.0001). Nurses’ CRRT knowledge is moderate, with gaps in complex aspects. Demographic factors do not influence competency, highlighting the need for targeted training over reliance on experience. Implement structured CRRT training programs (simulation, case studies), continuing education workshops, and mentorship initiatives to enhance knowledge and patient outcomes.
References
Andrade, B. R. P., Barros, F. M., Lúcio, H., Campos, J. F., & Silva, R. C. D. (2019). Training of intensive care nurses to handle continuous hemodialysis: a latent condition for safety. Rev Bras Enferm, 72(suppl 1), 105-113. https://doi.org/10.1590/0034-7167-2018-0013
Baldwin, I. C. (1997). Training, management, and credentialing for CRRT in the ICU. Am J Kidney Dis, 30(5 Suppl 4), S112-116. https://doi.org/10.1016/s0272-6386(97)90553-9
Baudoin, C. D., McCauley, A. J., & Davis, A. H. (2022). New Graduate Nurses in the Intensive Care Setting: Preparing Them for Patient Death. Crit Care Nurs Clin North Am, 34(1), 91-101. https://doi.org/10.1016/j.cnc.2021.11.007
Cuadros, K., Padilha, K., Toffoletto, M., Henríquez-Roldán, C., & Juan, M. (2017). Patient Safety Incidents and Nursing Workload. Revista Latino-Americana de Enfermagem, 25. https://doi.org/10.1590/1518-8345.1280.2841
Gaudry, S., Hajage, D., Benichou, N., Chaïbi, K., Barbar, S., Zarbock, A., Lumlertgul, N., Wald, R., Bagshaw, S. M., Srisawat, N., Combes, A., Geri, G., Jamale, T., Dechartres, A., Quenot, J. P., & Dreyfuss, D. (2020). Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials. Lancet, 395(10235), 1506-1515. https://doi.org/10.1016/s0140-6736(20)30531-6
Macedo, E., & Mehta, R. L. (2023). 67 - Continuous Renal Replacement Therapies for Acute Kidney Injury. In A. R. Nissenson, R. N. Fine, R. Mehrotra, & J. Zaritsky (Eds.), Handbook of Dialysis Therapy (Sixth Edition) (pp. 637-652). Elsevier. https://doi.org/https://doi.org/10.1016/B978-0-323-79135-9.00067-7
Nance, L. (2019). The Effect of a Focused Education Session on Continuous Renal Replacement Therapy (CRRT) Troubleshooting to Increase Knowledge and Self-Confidence in ICU Nurses.
Ostermann, M., Bellomo, R., Burdmann, E. A., Doi, K., Endre, Z. H., Goldstein, S. L., Kane-Gill, S. L., Liu, K. D., Prowle, J. R., Shaw, A. D., Srisawat, N., Cheung, M., Jadoul, M., Winkelmayer, W. C., & Kellum, J. A. (2020). Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference. Kidney Int, 98(2), 294-309. https://doi.org/10.1016/j.kint.2020.04.020
Rafii, F., Nasrabadi, A. N., & Tehrani, F. J. (2021). How Nurses Apply Patterns of Knowing in Clinical Practice: A Grounded Theory Study. Ethiop J Health Sci, 31(1), 139-146. https://doi.org/10.4314/ejhs.v31i1.16
Ronco, C., Bellomo, R., Kellum, J., & Ricci, Z. (2017). Critical care nephrology e-book. Elsevier health sciences.
Ronco, C., Bellomo, R., & Kellum, J. A. (2002). Continuous renal replacement therapy: opinions and evidence. Advances in renal replacement therapy, 9(4), 229-244.
Ronco, C., Bellomo, R., & Kellum, J. A. (2019). Acute kidney injury. Lancet, 394(10212), 1949-1964. https://doi.org/10.1016/s0140-6736(19)32563-2
Saad, A., Alsadi, J., Al-Absi, D. T., Almulla, M., Simsekler, M. C. E., Sadeq, A. A., Omar, F., Basha, M., Khatab, I., Khater, N. A., Molesi, A., & Anwar, S. (2024). An integrative risk assessment approach to enhancing patient safety in Continuous Renal Replacement Therapy (CRRT). Journal of Safety Science and Resilience, 5(3), 344-354. https://doi.org/https://doi.org/10.1016/j.jnlssr.2024.04.003
Stoltman, B. (2018). Continuous Renal Replacement Therapy: Educating Nurses for Prevention of Complications.
Vaara, S. T., Serpa Neto, A., Bellomo, R., Adhikari, N. K. J., Dreyfuss, D., Gallagher, M., Gaudry, S., Hoste, E., Joannidis, M., Pettilä, V., Wang, A. Y., Kashani, K., Wald, R., Bagshaw, S. M., Ostermann, M., & Investigators, o. b. o. t. S. v. A. i. o. R. R. T. i. A. K. I. (2024). Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis. Critical Care Explorations, 6(2), e1053. https://doi.org/10.1097/cce.0000000000001053
Yu, X., Ouyang, L., Li, J., Peng, Y., Zhong, D., Yang, H., & Zhou, Y. (2024). Knowledge, attitude, practice, needs, and implementation status of intensive care unit staff toward continuous renal replacement therapy: a survey of 66 hospitals in central and South China. BMC Nurs, 23(1), 281. https://doi.org/10.1186/s12912-024-01953-6
Brost, S. M. (2022). Implementation of an Advanced Training Program to Increase Nurses’ Knowledge of Continuous Renal Replacement Therapy Management West Virginia University].
Calabrese, E., & Musio, M. E. (2021). Nursing competence in CRRT: creation and validation of a measurement tool. Professioni infermieristiche, 74(4), 262. https://doi.org/10.7429/pi.2021.744262a
Cordoza, M., Rachinski, K., Nathan, K., Crain, E. B., Braxmeyer, D., Gore, S., Dubuc, S. D., & Wright, J. (2021). A Quality Improvement Initiative to Reduce the Frequency of Delays in Initiation and Restarts of Continuous Renal Replacement Therapy. J Nurs Care Qual, 36(4), 308-314. https://doi.org/10.1097/ncq.0000000000000557
Mehta, R. L. (2005). Continuous renal replacement therapy in the critically ill patient. Kidney Int, 67(2), 781-795. https://doi.org/10.1111/j.1523-1755.2005.67140.x
Mottes, T., Owens, T., Niedner, M., Juno, J., Shanley, T. P., & Heung, M. (2013). Improving delivery of continuous renal replacement therapy: impact of a simulation-based educational intervention. Pediatr Crit Care Med, 14(8), 747-754. https://doi.org/10.1097/PCC.0b013e318297626e
Nance, L. (2019). The Effect of a Focused Education Session on Continuous Renal Replacement Therapy (CRRT) Troubleshooting to Increase Knowledge and Self-Confidence in ICU Nurses.
Przybyl, H., Evans, J., Haley, L., Bisek, J., & Beck, E. (2017). Training and Maintaining: Developing a Successful and Dynamic Continuous Renal Replacement Therapy Program. AACN Adv Crit Care, 28(1), 41-50. https://doi.org/10.4037/aacnacc2017122
Stoltman, B. (2018). Continuous Renal Replacement Therapy: Educating Nurses for Prevention of Complications.
Tomasa Irriguible, T. M., Sabater Riera, J., Poch López de Briñas, E., Fort Ros, J., Lloret Cora, M. J., Roca Antònio, J., Navas Pérez, A., Ortiz Ballujera, P., Servià Goixart, L., González de Molina Ortiz, F. J., Rovira Anglès, C., Rodríguez López, M., & Roglan Piqueras, A. (2017). Current practice in continuous renal replacement therapy: An epidemiological multicenter study [10.1016/j.medine.2016.07.004]. Medicina Intensiva (English Edition), 41(4), 216-226. https://doi.org/10.1016/j.medine.2016.07.004
Viljoen, M., Coetzee, I., & Heyns, T. (2016). Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program. Am J Crit Care, 26(1), 70-76. https://doi.org/10.4037/ajcc2017412
Welbaum, C. (2021). Nurses' role in continuous renal replacement therapy: Expand your knowledge for safe, quality care. American Nurse Journal, 16(9), 26-30.
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