A new era of critical care began in the SICU, PICU and MICU with the rollout of Continuous Renal Replacement Therapy (CRRT) machines in early summer 2024. Unlike past practice, where dialysis nurses initiated the therapy and critical care nurses managed it post-initiation, ICU nurses are now fully trained to oversee the entire process. This change increases both the responsiveness of care and the autonomy of nursing practice.
The rollout required thoughtful collaboration across disciplines, with a multidisciplinary group of staff nurses, NPDP’s, leadership teams, providers, pharmacy, facilities and regulatory working together to select the upgraded CRRT machines. Nurse managers played key roles in training, while nurses at the bedside adapted workflows and learned the intricacies of the new technology. Fifty bedside nurses were involved in selecting the new Baxter CRRT machines.
“This allowed for seamless integration into daily practice and elevated the quality of renal support in critical situations,” says Ainsley Sherwood, RN, NPDP, who was instrumental to the entire effort. “By providing shift nurses with direct responsibility for a life-sustaining therapy, we hope to deepen their engagement and clinical confidence.”
By October 2024, ten patients had benefitted from the new machines in the ICUs, with many more throughout 2025.
“This was a huge undertaking across the hospital,” says Sue Hale, RN, NPDP. “The amount of time and effort put in by Ainsley, Phil Bowler, Kenan Avdibegovic, Jorel Gravelle, Edgar Etoundingono, Cindy Gebo and Alan Burnell – and so many others – was just incredible. What a privilege it has been for the ICU team to have them as partners.”
This effort exemplifies the Quality standard by enhancing care delivery through innovative, evidence-based practice. It also embraces Shared Decision-Making, as direct care nurses and nurse leaders worked side-by-side in implementing this change. Together, they fostered a culture of mutual respect and learning.
