The Role of Health Information Technology in the Management of Acute Kidney Injury
Acute Kidney Injury (AKI) is an emerging global healthcare issue. It is a prevalent, serious and life-threatening problem seen in 13–18% of all people admitted to hospital. All hospital patients are at risk of AKI either through their presenting illness or subsequent iatrogenic injury; older adults are particularly vulnerable with possible age-related reduction in their kidney function. The costs to the NHS of AKI are estimated to be between £434 million and £620 million per year, which is more than the costs associated with breast cancer, or lung and skin cancer combined.
The National Confidential Enquiry into Patient Outcome and Death described how complications of AKI such as acidosis, hyperkalaemia and sepsis were missed in 13% of cases, avoidable in 17% and managed badly in 22% of patient cases. Basic investigations of renal dysfunction, such as urinalysis and biochemistry, were often omitted. It is essential that relevant risk factors such as co-morbidities, previous chronic kidney disease, and hypovolaemia, are detected early and treated promptly.
Health information Technology can play a role in ensuring that patients who develop AKI are appropriately managed and supported to reduce further deterioration, long-term disability and death. Electronic prescribing systems in particular can alert prescribers to medicines known to be potentially nephrotoxic (ACE inhibitors, NSAIDS, aminoglycosides, contrast media), thus potentially ameliorating further injury to the kidneys. This project will focus on the role of electronic prescribing systems in the detection, management and treatment of AKI. A key aspect of this project will be assessing the particular design features of electronic prescribing systems that lead to system-related errors. Accordingly, the student will gain skills in quantitative and qualitative methodologies, which are widely used in health services research.
Applicants should hold an honours degree classified as 2.1 or higher in a relevant subject and also hold a relevant Master's degree. Applicants with non-UK qualifications should check equivalency on the 'country information' section of Durham's International Office web pages.