Training activity information
Details
Identify the correct therapy modes 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
- Appropriate modes of therapy
- Contraindications
- Managing risk
- Clinical requirement/prescription
- Continuous monitoring
- Top up education for bedside healthcare professionals
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 therapy modes in CRRT (e.g., SCUF, CVVH, CVVHD, CVVHDF)? What are the indications and contraindications for each mode based on patient status and renal pathophysiology?
- What specific understanding do you hope to achieve in selecting the appropriate CRRT mode for various clinical situations? What do you already know about the different CRRT modes?
- Discuss different clinical scenarios with your training officer to explore the rationale behind choosing specific therapy modes. Consider situations where the choice of mode might be challenging, and how you would approach this. Reflect on your current knowledge of CRRT modes.
In action
- Observe your approach to selecting the appropriate CRRT therapy mode (e.g., CVVH, CVVHD, CVVHDF) based on the patient’s clinical picture.
- What factors are you prioritising in your decision-making?
- What choices are you making about the initial therapy mode and why?
- What aspects of linking patient needs to therapy modes feel well-understood, and where do you need to think more deliberately?
- How well do you feel you are matching the therapy mode to the specific requirements of the patient?
- What challenges are you facing in differentiating between the different therapy modes and their indications?
- What are you learning about the practical considerations for choosing a particular mode as you engage in this activity?
- If the initial therapy mode doesn’t seem ideal, what alternative modes are you considering at that moment?
- What is informing these alternatives?
- What immediate input from the clinical team might be necessary if you are uncertain about the best therapy mode?
- Are you ensuring that the chosen therapy mode is within the established guidelines and prescription parameters?
On action
- What were the critical elements of the patient’s status and renal pathophysiology that guided your selection of therapy modes? What different therapy modes (e.g., SCUF, CVVH, CVVHD, CVVHDF) were considered? What were the distinguishing features of each mode in relation to the patient’s needs?
- What did you learn about the indications and contraindications for different CRRT therapy modes? How does the patient’s metabolic and fluid balance influence the choice of mode? Were there any challenging aspects in determining the most appropriate mode?
- What specific clinical scenarios will you research further to understand optimal therapy mode selection? How will you use your understanding of different modes to contribute to therapy prescription? Are there any institutional guidelines on therapy mode selection that you need to be more familiar with?
Beyond action
- Consider evaluating and re-evaluating your understanding of different CRRT therapy modes and their specific indications based on patient status and renal pathophysiology. Has your understanding become more nuanced with further experience?
- Have you observed clinical practice where different therapy modes were used for various patient presentations? What were the key factors influencing the choice? How does this compare to your understanding from this DTA?
- Revisit your reflect-on-action notes from this DTA. Have your insights into the advantages and disadvantages of different modes deepened? What further learning or discussion might be beneficial?
- Have you engaged in professional storytelling about cases where the therapy mode was critical to the patient’s outcome? What did you learn from these shared experiences?
- How has your knowledge of CRRT modes influenced your ability to understand and contribute to discussions about CRRT prescriptions?
- Have you applied this knowledge when reviewing patient management plans or considering potential adjustments to CRRT therapy? How has your ability to link patient physiology to the appropriate CRRT mode evolved? How has experience since influenced your wider practice?
- Identify the transferable skills you are developing, such as the ability to integrate physiological understanding with therapeutic options.
- Identify clear actions for continued development in your expertise regarding the selection and application of different CRRT therapy modes.
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. |