Acute Kidney Injury (AKI) Lead Advanced Clinical Practitioner
Becky Bonfield is the AKI Lead Advanced Clinical Practitioner at University Hospital Southampton (UHS), researching the self-management support and social networks that patients utilise after they’ve been in hospital with an AKI.
She is currently undertaking a five year part-time NIHR Doctoral Clinical Academic Fellowship (DCAF).
Becky is doing her DCAF alongside working as a Clinical Teaching Fellow for the MSc in Advanced Clinical Practice at the University of Southampton. She continues to work clinically within her DCAF, in her role of AKI Lead Advanced Clinical Practitioner.
Investigating patients’ support networks
Becky’s always had an interest in the patient, and their support networks’ role in preventing future AKIs. During her DCAF, she plans to use questionnaires to understand what patients’ social networks look like and the work that they do, as well as interviews with patients and their network members.
Becky has developed her own networks to reach this point, becoming part of both the NIHR Wessex Applied Research Collaboration and NIHR Southampton Biomedical Research Centre.
She is a member of the executive board for the Association of Nephrology Nurses (ANN), after working for two years as the lead for the AKI special interest group. In this role, she is the lead for communities of practice and takes an active role in the AKI one. She is also part of the education and conference planning committee. Alongside this, she is co-chair for the UK Kidney Association AKI Special interest Group innovation and improvement workstream.
Through both her local and national network, Becky has developed a team of supervisors and mentors who are ideally placed to ensure the successful completion of her project. In the longer term, she also hopes they will help her achieve her goal of becoming a consultant practitioner and associate professor leading her own research.
Improving the AKI service
Becky trained as an adult nurse, working in respiratory medicine, high dependency and critical care outreach, before moving into her role setting up the AKI team eight years ago.
Whilst working in critical care outreach, she completed her MSc in Advanced Clinical Practice. During this, she carried out research into fluid balance documentation. This sparked her interest in research and improvement work. Becky’s enthusiasm for this led to her current role in the AKI team.
She has developed the AKI service from a single person, providing only an inpatient service for patients with AKI stage 3, to that of a four-person team, who provide inpatient and outpatient care to patients from across the Integrated Care Board with AKI stage 2 and 3. The teams’ work has been shown to reduce inpatient length of stay, mortality and morbidity.
Whilst carrying out a review into AKI readmissions, Becky raised questions around the patients’ role in preventing future AKIs. She asked whether improving their knowledge around AKI would assist in reducing readmissions. To investigate this, she was awarded a Wessex HEE Individual Quality Improvement Fellowship.
Her work found more than 80% of patients did not know they had an AKI during their hospital stay, despite this information being given to them. This work led to a reduction in readmissions to hospital, and the development of an AKI nurse-led follow up service.
The importance of career support
When Becky joined the AKI team, she carried out some work with Dr Jacqui Prieto about AKI reduction in elective orthopaedic surgery.
It was Dr Prieto who first recognised Becky’s passion for investigation and improvement as the skills of clinical academic. She mentored Becky through her Wessex HEE Individual Quality Improvement Fellowship in 2018. Dr Kristin Veighey, deputy director of SOAR, was Becky’s clinical mentor.
Both Dr Prieto and Dr Veighey have continued to work to support Becky’s clinical academic career development. She has since gone on to secure a Wessex HEE Transition award in 2019 and an NIHR Predoctoral Clinical Academic Fellowship Bridge award in 2021, and now a prestigious NIHR DCAF.
“I feel that having Jacqui and Kristin’s support has been vital in ensuring that my clinical academic career has developed,” says Becky. “Through them I have been linked to SoAR, and have accessed opportunities that I didn’t even know existed.
“Alongside this, I recognise the importance of the fantastic support my line manager, Vickie Puride, and consultant, Dr Kirsty Armstrong, have given me.
“I really believe that having the support from the clinical teams, and the knowledge and skills from the clinical academics is the reason that I have been so successful.”