Training activity information
Details
Manage a patient undergoing CRRT, troubleshooting clinical issues as they arise
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
- Vital signs/blood pressure
- Electrolyte levels/acid base balance
- Waste products/poisons levels
- Anticoagulation monitoring
- Fluid balance
- Patient centred care and support
- Communication with the multidisciplinary team, patient and relatives
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 common clinical issues that can arise during CRRT (e.g., electrolyte imbalances, hypotension, circuit clotting)? What are the initial steps in troubleshooting these issues?
- What specific skills do you hope to gain in recognizing and responding to clinical problems during CRRT? What is your current understanding of potential CRRT complications?
- Discuss potential clinical scenarios and their management with your training officer. Consider what support or guidance you might need in the moment if unexpected issues arise. Reflect on your understanding of patient monitoring during CRRT.
In action
- Observe your actions as you monitor the patient and respond to any clinical issues that arise during CRRT.
- How are you prioritising and addressing these issues?
- What decisions are you making regarding adjustments to the therapy or other interventions?
- What aspects of managing clinical issues feel intuitive based on your understanding, and what requires more deliberate problem-solving?
- How effectively are you identifying and resolving the clinical issues that occur?
- What challenges are you encountering in managing the patient’s response to CRRT?
- What are you learning about the practical aspects of patient management and troubleshooting in this context as you are doing it?
- How does this activity relate to the learning outcome of evaluating and resolving clinical issues?
- If your initial response to a clinical issue is not effective, what alternative actions are you considering immediately?
- What immediate support or guidance might you need from senior colleagues when faced with a complex clinical problem?
- Are you ensuring that your management of clinical issues remains within your scope of practice and adheres to relevant guidelines?
On action
- Describe the specific clinical issues that you encountered while managing the patient on CRRT.
- What physiological parameters changed or triggered concern?
- What immediate actions were taken to address these issues?
- What did you learn about common clinical complications that can arise during CRRT?
- How effective were the troubleshooting strategies employed?
- What communication was necessary with the wider clinical team?
- What specific clinical scenarios require further understanding of troubleshooting protocols?
- How can you improve your response and decision-making in similar situations?
- What resources or support would be beneficial in managing complex CRRT issues?
Beyond action
- Consider evaluating and re-evaluating your approach to managing a patient on CRRT and the effectiveness of your troubleshooting actions.
- With more experience, are there alternative strategies you might now consider?
- Have you had experiences with subsequent training activities where you managed patients on CRRT or dealt with similar clinical issues?
- How did your responses compare?
- What have you learned from these subsequent experiences?
- Revisit your reflect-on-action notes from this DTA.
- Have your insights into the common clinical challenges and their management evolved?
- What new learning or actions might you now identify?
- Have you engaged in professional storytelling with peers or senior colleagues about challenging CRRT management scenarios?
- Did these discussions offer new perspectives on troubleshooting?
- How has this direct patient management experience enhanced your ability to anticipate and respond to clinical issues in CRRT and other critical care settings?
- Have you applied the problem-solving skills and clinical knowledge gained from this DTA in subsequent patient care? How has your confidence in managing complex patients developed? How has experience since influenced your wider practice?
- Identify the transferable skills you are developing, such as clinical decision-making under pressure, problem-solving, and patient assessment skills.
- Identify clear actions for continued development in your ability to proactively manage patients on CRRT and effectively troubleshoot clinical issues.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Evaluate and resolve clinical and technical issues relating to therapy. |
| # 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. |