Training activity information
Details
Identify the correct anticoagulation technique, with reference to patient coagulation status
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 clotting results
- Risk management
- Contraindications
- Continuous monitoring
- Safe storage of drugs
- Prescription
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 anticoagulation techniques used in CRRT (e.g., regional citrate, heparin)?
- How does a patient’s coagulation status influence the choice of anticoagulation?
- What are the risks and benefits of each technique?
- What specific skills do you hope to develop in assessing a patient’s coagulation status and determining the most appropriate anticoagulation strategy for CRRT?
- What do you already know about anticoagulation in CRRT?
- Discuss different patient coagulation profiles with your training officer and explore suitable anticoagulation options.
- Consider scenarios where there might be conflicting factors in choosing an anticoagulation technique, and how you would resolve these.
- Think about your understanding of the principles of coagulation and anticoagulation.
In action
- Pay attention to how you are assessing the patient’s coagulation status and then determining the appropriate anticoagulation technique for CRRT.
- What data are you focusing on?
- What decisions are you making about the type and dose of anticoagulation?
- What aspects of this process are you finding straightforward, and where do you feel less confident?
- How well do you believe you are matching the anticoagulation technique to the patient’s specific coagulation profile and risk factors?
- What difficulties are you encountering in interpreting the coagulation data or selecting the most suitable technique?
- What are you learning about the practical implications of different anticoagulation methods as you perform this task?
- If the initial anticoagulation approach seems unsuitable based on new information, what alternative strategies are you considering in real-time?
- What immediate advice or input from the medical team would be helpful if you are unsure about the best anticoagulation method?
- Are you ensuring that the chosen anticoagulation technique aligns with hospital protocols and patient safety guidelines?
On action
- What specific parameters of the patient’s coagulation profile did you review?
- What different anticoagulation techniques were considered?
- What factors helped you determine the most suitable technique for this patient?
- What did you learn about the advantages and disadvantages of various anticoagulation techniques used in CRRT?
- How does the patient’s risk of bleeding or clotting influence the choice of anticoagulation?
- Were there any conflicting indicators in the patient’s coagulation status?
- How were these addressed?
- What specific aspects of anticoagulation monitoring will you pay close attention to?
- Do you need to review the institutional protocols for anticoagulation in CRRT?
- How will this learning enhance your contribution to safe CRRT delivery?
Beyond action
- Consider evaluating and re-evaluating your understanding of different anticoagulation options in CRRT and their appropriateness based on patient coagulation status. Has your understanding of the risks and benefits of each approach evolved with further learning?
- Have you observed clinical practice where different anticoagulation strategies were employed? What patient factors influenced the choice? How does this align with your understanding from this DTA?
- Revisit your reflect-on-action notes from this DTA. Have your insights into the complexities of balancing anticoagulation and bleeding risks deepened? What further information or discussion might you find helpful?
- Have you engaged in professional storytelling about cases where anticoagulation management in CRRT presented challenges? What key learning points emerged from these discussions?
- How has your knowledge of anticoagulation in CRRT influenced your ability to understand and contribute to discussions about patient management?
- Have you applied this knowledge when reviewing patient charts or considering potential complications during CRRT? How has your awareness of the importance of tailored anticoagulation strategies developed? How has experience since influenced your wider practice?
- Consider how the learning from this DTA will support you in preparing for assessments, where you might need to justify the anticoagulation regimen for a patient on CRRT.
- Identify the transferable skills you are developing, such as the ability to assess and manage risks associated with medical interventions.
- Identify clear actions for continued development in your understanding of anticoagulation principles and their application in the context of CRRT.
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. |
| # 6 |
Outcome
Identify appropriate anticoagulation techniques, with reference to patient needs. |