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Decreasing Adverse Events in Pediatric Patients With End-Stage Renal Disease

Childs, Gwendolyn D.; Sims, Rebekah

The Journal for Healthcare Quality (JHQ): January/February 2019 - Volume 41 - Issue 1 - p 59–64
doi: 10.1097/JHQ.0000000000000172
Translation of Research into Healthcare Quality Practice

ABSTRACT Children with end-stage renal disease (ESRD) are at a higher risk of adverse events when they live at a distance from a pediatric facility with specialty services specific to the disease process. At a children's hospital in the southeast, a dialysis unit provides care for 27 patients with chronic ESRD. Nineteen of the 27 patients live more than 1 hour away from the children's hospital. Over the past 3 years, adverse events have occurred in patients being treated at another hospital. These adverse events included sepsis, bacterial and fungal infections, and compromised residual glomerular filtration rate because of the administration of nephrotoxic medications. The purpose of this article is to describe the findings from an improvement effort aimed at decreasing adverse events in the pediatric patient population with ESRD who require urgent or emergent care using an emergency room dialysis card as a communication tool for patients, families, and providers.

For more information on this article, please contact Gwendolyn D. Childs at

This project was supported by the Jarman Lowder Clinical Scholars Program and the Children's of Alabama—University of Alabama at Birmingham School of Nursing Academic-Clinical Partnership.

The authors declare no conflicts of interest.

© 2019 National Association for Healthcare Quality
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