Digital monitoring of urine output to reduce missed care
Research type
Research Study
Full title
Digital monitoring of urine output as an intervention to reduce the incidence of missed care and improve timely acute kidney injury detection in patients following hip fracture surgery.
IRAS ID
291003
Contact name
Martin Whyte
Contact email
Sponsor organisation
University of Surrey
Duration of Study in the UK
3 years, 1 months, 31 days
Research summary
Assessment of urine output is a vital assessment for good patient care in hospitals and for the prevention of patient deterioration, including acute kidney injury (AKI). AKI affects at least 10% of hospital admissions (1) and in patients following hip fracture surgery, incidence is even greater (2–5). AKI is associated with increased short- and long-term morbidity and costs estimated at least £1 billion per year in the NHS (6). In 20-30% cases, AKI is preventable (7) which has driven interest in strategies to improve early recognition and the delivery of basic elements of AKI care, including urine output monitoring. Low urine output, oliguria, may highlight the development of AKI earlier than blood tests.
Urine output plays an equal part in the Kidney Disease Improving Global Outcomes (KDIGO) AKI criteria (8), but the implementation of this biomarker is challenging, and its clinical importance is less well understood (9,10). Low urine output, oliguria, is an early warning sign for patient deterioration and may be the first indication of AKI (11–14), but there are no definitive guidelines for best practice, including frequency of measurement. It is recognised that the implementation of urine output monitoring is resource intensive and may be only partially complete, if at all (15,16). This could be defined as ‘missed care’ (17,18) and leads to negative outcomes for patients, staff and organisations (18,19).
This study will investigate the use of Clarity RMS, a digital system that continuously measures urine flow, and automatically transmits urine output volume data, including notifications to healthcare staff in real-time.
In patients following hip fracture surgery, a mixed methods study will be undertaken to identify if a digitally enabling device measuring urine output can decrease incidence of missed care on a hospital ward in patients post- hip fracture surgery.REC name
East of England - Essex Research Ethics Committee
REC reference
23/EE/0154
Date of REC Opinion
1 Sep 2023
REC opinion
Further Information Favourable Opinion