Training activity information
Details
Assist and advise the clinical team with the prescription of therapy for a range of patients
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Patient centred care and support
- Communication with the multidisciplinary team, patient and relatives
- Vital signs/blood pressure
- Electrolyte levels/acid base balance
- Waste products/poisons levels
- Anticoagulation monitoring
- Fluid balance
- Risk management
- Continuous monitoring
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What factors influence the prescription of CRRT (e.g., patient’s clinical status, fluid balance, electrolyte levels, metabolic derangements)? What are the different prescription parameters and their implications?
- What specific knowledge and skills do you hope to develop in contributing to the CRRT prescription process? What is your current understanding of the principles of CRRT prescription?
- Review patient case studies and their CRRT prescriptions.
- Discuss the principles of CRRT prescription with senior colleagues to gain clarity.
- Consider how you would integrate various clinical parameters into a prescription recommendation.
In action
- Pay attention to how you are contributing to the discussion and offering advice regarding the CRRT prescription based on different patient scenarios4.
- What information are you prioritising in your input?
- What recommendations are you making and what is your reasoning behind them?
- What aspects of contributing to prescription decisions feel more confident, and where do you feel you need to consolidate your knowledge?
- How effectively are you able to analyse patient information and contribute relevant advice to the clinical team?
- What challenges are you facing in understanding the nuances of different patient cases and their implications for CRRT prescription?
- What are you learning about the collaborative aspects of patient care and the factors that influence therapy prescriptions as you participate?
- If your initial suggestions are not aligned with the team’s thinking, how are you adapting your approach and considering alternative perspectives in the moment?
- What immediate clarification or further information might you need from the team to contribute more effectively?
- Are you ensuring that your advice is based on current evidence and best practices, and is within your level of ability?
On action
- Describe the different patient scenarios discussed with the clinical team.
- What were their key clinical characteristics?
- What specific aspects of therapy prescription were under consideration (e.g., mode, settings, anticoagulation)?
- What were the various perspectives and considerations of the team members?
- What are the key factors that influence CRRT therapy prescription for different patient types?
- How does collaboration and communication within the clinical team contribute to optimal prescribing?
- What is the role of evidence-based practice in CRRT prescription?
- What specific areas of CRRT prescription do you need to develop a deeper understanding of?
- How can you effectively communicate your knowledge and contribute to the team’s decision-making?
- What clinical guidelines or research articles will you refer to in the future?
Beyond action
- With more knowledge and experience, are there additional considerations you would now bring to the discussion?
- Have you had opportunities to observe how experienced colleagues contribute to CRRT prescription discussions? What approaches or insights did they offer that you can learn from?
- Revisit your reflect-on-action notes from this DTA. Have your insights into the complexities of tailoring CRRT prescriptions to individual patient needs deepened? What further learning or resources might enhance your ability to advise the team?
- Have you engaged in professional storytelling with colleagues about challenging or interesting cases where the CRRT prescription was a key element of management? Did these discussions broaden your understanding of prescription nuances?
- How has this experience of contributing to prescription discussions enhanced your understanding of the clinical reasoning behind therapy choices in CRRT and potentially other interventions?
- Have you applied your knowledge of CRRT principles and patient needs when reviewing prescriptions or participating in ward rounds? How has your confidence in offering relevant advice developed? How has experience since influenced your wider practice?
- Identify the transferable skills you are developing, such as critical thinking, communication within a multidisciplinary team, and the application of knowledge to clinical problem-solving. Identify clear actions for continued development in your expertise regarding CRRT prescription and your ability to effectively advise the clinical team.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 3 |
Outcome
Prescribe therapies for clinical scenarios related to renal replacement therapies. |
| # 4 |
Outcome
Evaluate and manage risk to practice safely in all elements of patient care. |
| # 5 |
Outcome
Describe the renal replacement therapy modalities, with reference to patient needs. |
| # 6 |
Outcome
Identify appropriate anticoagulation techniques, with reference to patient needs. |