Training activity information
Details
Identify the correct principle of active mechanism with reference to patient status and renal pathophysiology
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
- Diffusion
- Convection
- Fluid removal
- Contraindications
- SOPs
- Local and national guidance
- Risk management
- Continuous monitoring
- Top up education for bedside healthcare professionals
- Safe storage of drugs
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 are the different principles of active mechanisms in CRRT (e.g., convection, diffusion, filtration)? How do different patient conditions and renal pathophysiology influence the choice of these principles?
- What specific insights do you hope to gain regarding the application of different CRRT principles based on patient needs? What is your current understanding of these principles?
- Discuss this training activity with your training officer to ensure you understand the expected level of detail. Think about potential scenarios where different principles might be indicated, and how you would justify your choice. Consider your confidence level in differentiating these principles.
In action
- Focus on how you are linking the patient’s condition and renal pathophysiology to the principles of active mechanisms in CRRT.
- What is your thought process for making these connections?
- What decisions are you making about which principles are most relevant for this specific patient at this time?
- What aspects of this identification process feel more automatic, and where do you need to consciously apply your knowledge?
- How confident are you in identifying the correct principles based on the information available?
- What difficulties are you encountering in relating the patient’s status to the underlying CRRT mechanisms?
- What insights are you gaining about these principles and their application as you are working through this?
- How does this activity reinforce your understanding of the different CRRT modalities (SCUF, CVVH, CVVHD, CVVHDF) mentioned in the indicative content?
- If you are unsure about the correct principle, are there alternative ways you could approach the problem, such as consulting guidelines or seeking clarification?
- What immediate support might be beneficial if you are struggling to make the connection between patient factors and CRRT principles?
- Are you ensuring that your identification of the active mechanism aligns with the overall goals of the CRRT therapy?
On action
- What aspects of the patient’s clinical picture and renal function were key in determining the active mechanism?
- What were the different active mechanisms considered?
- What information helped you differentiate between the available options?
- What did you learn about the principles underlying different active mechanisms in CRRT?
- How does the patient’s physiological state influence the choice of active mechanism?
- Were there any complexities or uncertainties in linking the patient’s condition to the most appropriate mechanism?
- What specific patient parameters will you focus on to guide your choice of active mechanism?
- Do you need to further explore the theoretical basis of different active mechanisms?
- How will this learning enhance your ability to advise the clinical team on the most suitable approach?
Beyond action
- Consider evaluating and re-evaluating your understanding of different CRRT principles (e.g., convection, diffusion) in relation to patient needs and renal pathophysiology. Has your understanding evolved with further study or clinical exposure?
- Have you encountered clinical scenarios where the choice of CRRT principle was debated or adjusted? How did your understanding from this DTA help you appreciate the rationale?
- Revisit your reflect-on-action notes from this DTA. Have your insights into the clinical implications of different principles deepened? What further learning or clarification might you now seek?
- Have you engaged in professional storytelling with colleagues about cases where the underlying principles of CRRT were crucial for patient management? Has this provided new perspectives?
- Recognise that this DTA contributes to your overall training experience. How has understanding these principles enhanced your ability to understand discussions about CRRT prescriptions or patient responses to therapy?
- Have you applied this knowledge when reviewing patient data or discussing CRRT management with the team? How has your ability to link physiological derangements to the appropriate CRRT mechanism developed? How has experience since influenced your wider practice?
- Identify the transferable skills you are developing, such as the ability to apply scientific principles to clinical decision-making.
- Identify clear actions for continued development in your understanding of the theoretical underpinnings of CRRT and their practical application.
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. |