Who should manage CRRT in the ICU? The nursing viewpoint.

Continuous renal replacement therapy (CRRT) is performed in critical care units around the world with various levels of involvement from critical care and nephrology nurses. In this article, factors affecting the delivery of nursing care and the particular expertise nephrology and critical care nurses have in the area of CRRT are examined. Based on this discussion, three proposed models of nursing care for the patient receiving CRRT are discussed: the Nephrology Nursing Model, the Critical Care Model, and the Collaborative Model. Based on related research findings and a comparison of the models, the Collaborative Model is the preferred one, as it brings the highest level of expertise directly to the patient. For the Collaborative Model to work, a framework for collaboration and a high degree of commitment from both specialties must be maintained.