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ICU quality and management tools

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Intensive Care Unit (ICU) Quality and Management Tools refer to a range of strategies, technologies, and practices aimed at improving patient outcomes, operational efficiency, and safety within the Intensive Care Unit (ICU).

ICU quality tools

Quality tools include:[1]

  • Checklists (items rated as yes/no/not applicable).
  • Templates for goal setting or structured communication (more open format providing ability to add free text responses with items as prompts).
  • Care bundles, including ABCDE(F) bundle (Assess, prevent and manage pain, Both spontaneous awakening trials and spontaneous breathing trials, Choice of analgesia and sedation, Delirium assessment, prevention and management, Early mobility and exercise, Family engagement and empowerment).

Quality improvement tools may be used to improve subjects such as:[2]

Scoring systems, which describe ICU populations and explain their different outcomes, include the following most frequently used systems:

Quality initiatives can increase the quality of care and patient safety are major and feasible goals. Such systems include:

  • Epimed Monitor, which may facilitate the process of care on a daily basis and provide data for an in-depth analysis of ICU performance.

ICU management tools

ICU management tools include:

Severity assessment tools

Five of the current scoring systems include:[3]

Risk stratification tools

Risk stratification tools include the following:[4]

  • Sabadell score and the tool developed by Daly, designed to predict hospital mortality following ICU discharge.
  • Modified Early Warning Score (MEWS), which predicts ICU readmission within 72 hours of discharge, and Pediatric early warning signs (PEWS) score
  • Stability and Workload Index for Transfer (SWIFT) score and the Frost nomogram, developed to predict ICU readmission following ICU discharge.
  • Minimizing ICU Readmission (MIR) score, designed to predict the combined outcome of patient death or ICU readmission seven days prior post-ICU discharge.

See also

References

  • Gallesio, Antonio O.; Ceraso, Daniel; Palizas, Fernando (July 2006). "Improving Quality in the Intensive Care Unit Setting". Critical Care Clinics. 22 (3): 547–571. doi:10.1016/j.ccc.2006.04.002. ISSN 1557-8232. PMID 16893740.
  • Garland, Allan (June 2005). "Improving the ICU: part 1". Chest. 127 (6). American College of Chest Physicians: 2151–64. doi:10.1378/chest.127.6.2151. PMID 15947333.
  • Garland, Allan (June 2005). "Improving the ICU: part 2". Chest. 127 (6). American College of Chest Physicians: 2165–79. doi:10.1378/chest.127.6.2165. PMID 15947334.
  • Knaus, William A.; Draper, Elizabeth A.; Wagner, Douglas P.; Zimmerman, Jack E. (October 1985). "APACHE II: a severity of disease classification system". Critical Care Medicine. 13 (10): 818–29. doi:10.1097/00003246-198510000-00009. PMID 3928249.
  • McMillan, Tracy R.; Hyzy, Robert C. (February 2007). "Bringing quality improvement into the intensive care unit". Critical Care Medicine. 35 (2 Suppl). Society of Critical Care Medicine and Lippincott Williams & Wilkins: S59 – S65. doi:10.1097/01.CCM.0000252914.22497.44. PMID 17242607.
  • The Epimed Monitor ICU Database®: a cloud-based national registry for adult intensive care unit patients in Brazil. Zampieri FG, Soares M, Borges LP, Salluh JIF, Ranzani OT.Rev Bras Ter Intensiva. 2017 Oct-Dec;29(4):418-426. doi: 10.5935/0103-507X.20170062. Epub 2017 Nov 30.
  • New perspectives to improve critical care benchmarking. Salluh JIF, Chiche JD, Reis CE, Soares M.Ann Intensive Care. 2018 Feb 2;8(1):17. doi: 10.1186/s13613-018-0363-0.
  • How to evaluate intensive care unit performance during the COVID-19 pandemic. Zampieri FG, Soares M, Salluh JIF.Rev Bras Ter Intensiva. 2020 Jun;32(2):203-206. doi: 10.5935/0103-507x.20200040. Epub 2020 Jul 13.
  1. ^ Allum, Laura, et al. "Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools." Intensive and Critical Care Nursing 73 (2022): 103302.
  2. ^ Allum, Laura, et al. "Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools." Intensive and Critical Care Nursing 73 (2022): 103302.
  3. ^ Chalmers, James D., et al. "Severity assessment tools to guide ICU admission in community-acquired pneumonia: systematic review and meta-analysis." Intensive care medicine 37 (2011): 1409-1420.
  4. ^ Hosein, F. Shaun, et al. "A systematic review of tools for predicting severe adverse events following patient discharge from intensive care units." Critical Care 17 (2013): 1-10.
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