Inclusion, exclusion and audit criteria

DEMO DATA

Who to include, who to exclude, and the 26 AKI audit criteria measured in this cycle.

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Inclusion criteria
  • •Adults aged 16 years or older, unless locally adapted
  • •Patients with suspected or confirmed acute kidney injury
  • •Patients with AKI warning stage 1, 2 or 3
  • •Patients admitted to hospital or reviewed in an acute assessment setting during the audit period
  • •Patients managed in the selected wards, units, departments or pathways
  • •Electronic, paper or hybrid records depending on local setup
Exclusion criteria & limitations
  • •Patients under 16 years old unless locally adapted
  • •Pregnant or recently pregnant patients unless locally adapted to maternity guidance
  • •Kidney transplant patients unless locally adapted to specialist renal transplant guidance
  • •Patients on established chronic renal replacement therapy where local policy excludes them
  • •Patients without suspected or confirmed AKI
  • •Duplicate admissions or duplicate records
  • •Records outside the selected audit period
  • •Records unavailable for review
  • •Records where local governance approval is required but has not been obtained
  • •Direct patient identifiers must not be entered into the tool
Audit criteria (26)
Aligned with NICE NG148, NICE QS76 and local trust AKI policy. Compliance is calculated using Yes and No responses only; Not applicable and Unable to determine are excluded from the denominator.
  1. C1
    AKI warning stage or suspected AKI documented.
    Target ≥ 90% · auto-computed from submissions
  2. C2
    AKI recognised and documented by the clinical team.
    Target ≥ 90% · auto-computed from submissions
  3. C3
    Clinical review completed within the locally agreed timeframe for AKI stage and clinical condition.
    Target ≥ 90% · auto-computed from submissions
  4. C4
    Senior review completed where required by local policy.
    Target ≥ 90% · auto-computed from submissions
  5. C5
    Likely cause or contributing factors for AKI documented.
    Target ≥ 90% · auto-computed from submissions
  6. C6
    Volume status assessed.
    Target ≥ 90% · auto-computed from submissions
  7. C7
    Fluid management plan documented where clinically relevant.
    Target ≥ 90% · auto-computed from submissions
  8. C8
    Urine output documented or urine output monitoring commenced where appropriate.
    Target ≥ 90% · auto-computed from submissions
  9. C9
    Urinalysis completed where appropriate.
    Target ≥ 85% · manual review
  10. C10
    Obstruction considered where clinically relevant.
    Target ≥ 85% · auto-computed from submissions
  11. C11
    Renal tract imaging requested or completed where indicated.
    Target ≥ 85% · manual review
  12. C12
    Medication review completed.
    Target ≥ 90% · auto-computed from submissions
  13. C13
    Nephrotoxic, renally cleared or AKI-relevant medicines reviewed.
    Target ≥ 90% · auto-computed from submissions
  14. C14
    Dose adjustment considered for renally cleared medicines where relevant.
    Target ≥ 85% · auto-computed from submissions
  15. C15
    Sepsis considered where clinically relevant.
    Target ≥ 90% · auto-computed from submissions
  16. C16
    Hyperkalaemia checked or managed where relevant.
    Target ≥ 90% · auto-computed from submissions
  17. C17
    Repeat creatinine / U&E monitoring plan documented.
    Target ≥ 90% · auto-computed from submissions
  18. C18
    Renal referral completed where indicated by local policy.
    Target ≥ 90% · auto-computed from submissions
  19. C19
    Critical care, outreach or urgent escalation completed where indicated.
    Target ≥ 90% · auto-computed from submissions
  20. C20
    AKI stage progression, stability or recovery documented.
    Target ≥ 85% · auto-computed from submissions
  21. C21
    Discharge summary includes AKI episode and follow-up plan where relevant.
    Target ≥ 90% · auto-computed from submissions
  22. C22
    Post-discharge kidney function monitoring plan documented where relevant.
    Target ≥ 85% · auto-computed from submissions
  23. C23
    Patient advice about kidney health, medicines or follow-up documented where appropriate.
    Target ≥ 80% · auto-computed from submissions
  24. C24
    Reason for delayed, missing or incomplete AKI management documented where applicable.
    Target ≥ 85% · manual review
  25. C25
    Documentation is clear enough for another clinician to understand AKI recognition, management and follow-up plan.
    Target ≥ 90% · manual review
  26. C26
    Any AKI-related safety concern was escalated or actioned where identified.
    Target ≥ 100% · manual review