Use of hyperkalaemia order set may improve SPS administration

Application of a hyperkalaemia order set has resulted in appropriate use of sodium polystyrene sulfonate (SPS), a common treatment option for hyperkalaemia, at a 979-bed community teaching hospital, reports a study.

“No consensus guidelines exist to assist practitioners in the management of hyperkalaemia,” according to the authors.

This study sought to determine whether use of a hyperkalaemia order set was associated with appropriate use of SPS. The authors assessed the appropriateness of orders for SPS in a retrospective cohort of adult patients and collected data from 1 December 2015 to 31 December 2016. They randomly matched 2:1 all orders for SPS not from an order set to those from the order set.

Appropriate use was defined as potassium level >5.5 mEq/L and no contraindications to use. The absolute difference in the proportion of patients with appropriate SPS use in the order set group vs the nonorder set group was the primary outcome.

Of the 120 patients included in the analysis, 40 were assigned to the order set group and 80 to the nonorder set group. Baseline characteristics were comparable between the two groups.

Significantly more patients in the order set group had appropriate use of SPS than those in the nonorder set group (97.5 percent vs 60 percent; p<0.001). Use of the order set also led to a higher reduction in serum potassium, quicker follow-up potassium level and lower incidence of gastrointestinal adverse effects.

“Requiring the use of the hyperkalaemia order set for administration of SPS may enhance patient care and safety,” the authors said.