Creating a Specialized Neonatal Continuous Renal Replacement Therapy (CRRT) Program in a Level IV NICU: A Needs Assessment

POSTER

Creating a Specialized Neonatal Continuous Renal Replacement Therapy (CRRT) Program in a Level IV NICU: a needs assessment Megan Bolt, BSN, RN; Kyler Rendle, BN, RN; Nicole Reynolds, BSN, RN; Allison Struiksma, BSN, RN; Dr. Kelly Mansfield, PhD, RN Key Take Away . Developing a specialized Continuous Renal Replacement Therapy (CRRT) program in the Neonatal Intensive Care Unit (NICU) is both feasible and essential for improving patient outcomes, enhancing care quality, and ensuring staff competency. Background Results •CRRT can supports critically ill neonates. Yet despite advancements in CRRT technology, implementing neonatal CRRT programs faces challenges due to education gaps and staffing constraints. • Technological Advances •Implementation Challenges •Current Care Process •Need for Specialized Training •Benefits of Specialized Teams •Standardization and Equity •Financial Impact Barriers to Implementing a Dedicated NICU Team Lack of Nursing Support (n=22) 17% The purpose of this Doctor of Nursing (DNP) needs assessment was to develop a program plan for a neonatal CRRT program in a Level IV NICU building on best practices and the needs of the NICU population Chart Review • Weights ranging from 2.75 kg to 4.3 kg and CRRT duration ranging from 2 to 56 days. Education (n=27) 21% Purpose • Additional training for RNs (n=35) 27% Lack of Patients and Expereince (n=16) 12% Additional training for RNs Staffing Difficulties Staffing Difficulties (n=29) 23% Lack of Patients and Expereince Education Comfortability with Common NICU Diagnosis (n=77) 70 SWOT Analysis - Strengths: Patient-centered care, Collaborative structure, 1- Platform - Weaknesses: Knowledge gaps, Large, combined team, Limited resources - Opportunities: Integration of CSLs out of staffing, Improved educational processes, Process optimization - Threats: Continued financial constraints, Patient eligibility criteria, Sustainability concerns Financial Analysis • The CRRT day charge is $3511.10, and the daily cost is $1020.90. • 2024 daily margin of $1582.27 • Neonatal patients brought in approximately $119,286.72 in 2024. Lack of Nursing Support Benchmarking • Revealed specialized teams, resource/primer RNs, and education to maintain competency 60 50 Methods • • • • Survey of the clinicians and nurses in the NICU, PICU, and CICU to understand barriers and facilitators SWOT Analysis Discussions with stakeholders and benchmarking against other NICUs Present survey results and a strategic plan for stakeholders 40 30 20 Conclusions • Recommendations: - Dedicated neonatal CRRT program - Improved education Model - Clinical Support Leaders (CSLs) out of staffing to support CRRT nurses • • Sustainability Further Potential: Phase two of the project will move forward with implementing the steps needed to build a specialized neonatal CRRT program. 10 0 @uofunursing @utnurseresearch