An essential part of the guideline development process is the formulation of a dissemination and implementation strategy.


In 2004, the first stage of an Iron implementation project was commenced. This involved performing a clinical audit of six renal centres for their practices and procedures regarding iron levels for their patients and comparison of these results against the KHA-CARI Guidelines on iron and haemoglobin targets in use at that time.

In 2005, the second stage of this project was begun. Six renal units were monitored for their iron management and ferritin, haemoglobin, TSAT and epoetin use. Three of the six units actively made changes in their iron management practices to reflect the guidelines. Strategies to implement the CARI iron guideline differed in each unit. Each unit focussed on their management of in-centre haemodialysis patients. Wide variation of iron indices was observed across the units. Statistically significant improvements in median ferritin levels were seen across the study.

Publications & Presentations

Implementing iron management clinical practice guidelines in patients with chronic kidney disease having dialysis
Irving MJ, Craig JC, Gallagher M, McDonald S, et al. MJA 2006:185(6):310-314[PubMed abstract]

43rd Australian & New Zealand Society of Nephrology {ANZSN); 2007 Sept; Gold Coast, Qld
Effectiveness of multifaceted intervention strategy for the Caring for Australasians with Renal Impairment (CARI) Guidelines [abstract no: 0041] Irving M, Gallagher M, Frommer M, Polkinghorne K, McDonald S, Roger S, Walker R, Craig JC Nephrology 2007; 12 Suppl 2: A11[abstract]

4th Annual Guidelines International Network (G-I-N) Conference: Collaboration in Clinical Practice Guidelines; 2007 Aug 22-25; Toronto, Canada
Implementation of clinical practice guidelines: overcoming barriers to implementation of iron management guidelines in chronic kidney disease patients [abstract no: B65] Michelle Irving, Martin Gallagher, Rowan Walker, Michael Frommer, Jonathan Craig[Program]