Exploration of digital technology to monitor urine output to improve management of patients admitted to hospital with a fractured hip
Accurate fluid monitoring is fundamental to the delivery of good acute care in hospitals. Reduced urine output may be the first indication of kidney damage, reflecting an early warning sign for patient deterioration. However, urine output is monitored poorly, in part due to a lack of staff time on the wards. There is an urgent need to improve patient care. This study will investigate the use of a technological solution to pre-empt AKI, without encroachment on limited staff time. The NHS manages over 66,000 hip fractures a year, and is an appropriate condition for research into fluid monitoring, as over 20 per cent developing kidney damage within the first 48 hours of hospitalisation. A real-time, urine-flow monitoring device will be tested to establish acceptability to staff, whether the device can decrease the incidence of missed care and if kidney damage can be detected earlier than the current gold-standard approach.
Start date1 January 2021
Duration3-4 years full-time (or 6-8 years part-time)
Funding sourceThe University of Surrey and NIHR Applied Research Collaboration
This research project has funding attached. Funding for this project is available to UK/EU students. The funding package for this studentship scheme is as follows:
- Full UK/EU tuition fee waiver
- Stipend at UKRI rates (£15,285 p.a.)
- Personal Computer (provided by the host department).
Oliguria (reduced urine output) may be the first indication of Acute Kidney Injury (AKI) and an early warning for patient deterioration. The incidence and consequence of AKI is likely to be under-reported. In the UK, over 66,000 suffer a hip fracture annually and are at risk of complications from inadequate fluid monitoring due to frailty and co-morbidities. Around 20 per cent develop AKI within the first 48 hours of admission - associated with delirium, prolonged hospital stay and increased mortality.
- Is a digitally-enabling device for urine collection acceptable to healthcare staff?
- Can a digitally-enabling device, measuring urine output, decrease incidence of missed care?
- Can oliguria detect patients earlier than serum Creatinine-based AKI definitions?
WSHFT is an 870-bed acute trust operating across two sites, Worthing and Chichester. This is a mixed methods design.
- Over 12-months, patients with a fractured hip requiring surgery will be investigated for 72 hours post-operatively with urine output monitored digitally, or per standard practice. The primary outcome is time to AKI using oliguria criteria versus blood creatinine.
- A purposive sample of staff will be invited to take part in semi-structured face-to-face interviews to identify staff views on acceptability, barriers, facilitators and optimisation of the intervention.
Dr Martin Whyte is a Clinical Academic and works as a Consultant Physician in Acute and General Medicine and Senior Lecturer at the University of Surrey since 2012. Professor Forni’s main area of interest and expertise is acute kidney injury in which he has published widely. Professor Forni also sits on the national Clinical Reference Group (CRG) for AKI.
Applicants should have at least MSc or equivalent, plus Royal College of Nursing registration.
UK and EU students are eligible for this studentship.
IELTS requirements: 7.0 or above.
How to apply
Please apply for this PhD through the Biosciences and Medicine PhD applications portal ('Apply' tab)
Potential students should complete a cover letter demonstrating their interest in, and suitability for, the project. We would also like a CV detailing your previous research experience, and two academic references.