Implementation Strategies for Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action) to Prevent Neonatal Medication-Induced Kidney Injury

Sadie B Stone; Elizabeth Bisaccia; Mary Soliman Zakhary; Ferras Bashqoy; Deborah Wagner; Christine Stoops

doi:10.5863/1551-6776-28.4.287

Implementation Strategies for Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action) to Prevent Neonatal Medication-Induced Kidney Injury

J Pediatr Pharmacol Ther. 2023;28(4):287-296. doi: 10.5863/1551-6776-28.4.287. Epub 2023 Aug 9.

Authors

Sadie B Stone¹, Elizabeth Bisaccia², Mary Soliman Zakhary³, Ferras Bashqoy⁴, Deborah Wagner⁵, Christine Stoops⁶

Affiliations

¹ Department of Pharmacy (SBS), Children's of Alabama, Birmingham, AL.
² Department of Pharmacy (EB), Advocate Aurora Health, Park Ridge, IL.
³ Clinical Operations Department (MSZ), Med Communications, Inc, Memphis, TN.
⁴ Department of Pharmacy (FB), Hassenfeld Children's Hospital at NYU Langone Health, New York, NY.
⁵ Department of Pharmacy (DW), Michigan Medicine, Ann Arbor, MI.
⁶ Department of Pediatrics (CS), University of Alabama at Birmingham, Birmingham, AL.

Abstract

Acute kidney injury (AKI) is a common complication among patients admitted to the neonatal intensive care unit. Nephrotoxic medications (NTMs) are known to increase the incidence of AKI, but the use of these -medications is often unavoidable. Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action) is a -quality improvement (QI) project that may be implemented at individual institutions and aims to systematically identify AKI in neonates and infants receiving NTMs. The purpose of this review is to describe nephrotoxic AKI in the neonatal population, introduce the Baby NINJA QI project and its potential to reduce neonatal AKI, and outline strategies for effective implementation of Baby NINJA.

Keywords: acute kidney injury; infant, newborn; intensive care units, neonatal; nephrotoxic medication; quality improvement.