Testing the implementation of an electronic process-of-care checklist for use during morning medical rounds in a tertiary intensive care unit: a prospective before–after study

Conroy, Karena M; Elliott, Doug; Burrell, Anthony R

doi:10.1186/s13613-015-0060-1

Annals of Intensive Care

Table 1 Process-of-care statements in the e-checklist

From: Testing the implementation of an electronic process-of-care checklist for use during morning medical rounds in a tertiary intensive care unit: a prospective before–after study

Label	Statement	Response options^a	Inclusion criteria
Ventilated^b	Is the patient invasively ventilated?	Yes/No	Patients with endotracheal or tracheostomy tubes only
HOB	Patient is positioned with the head of the bed raised >30 degrees	Yes/No/NA (not ventilated or unit policy e.g. patient haemodynamically unstable or needing large doses of noradrenaline, or has unstable spinal or pelvic injuries)	Invasively ventilated patients only
Wean	Patient’s readiness to be weaned from mechanical ventilation has been assessed	Yes/No/NA (not ventilated)	Invasively ventilated patients only
Sedation	Sedation target set, sedation level assessed and managed	Yes/No/NA (not ventilated or has not required sedation in the past 24 h)	Patients who have an artificial airway and require sedation for facilitation of ventilation
Analgesia	Pain has been assessed, a management plan set and progress reviewed	Yes/No/NA (pain assessment cannot be determined due to patient’s condition)	All patients—includes recognition that a patient has no pain or it cannot be determined, e.g. patient is unresponsive
DVT_proph	Mechanical and/or drug DVT prophylaxis is being administered or applied	Yes/No/NA (clinical contraindication to both forms of prophylaxis)	All patients
SUP	Stress ulcer prophylaxis is being administered	Yes/No/NA (unit policy, e.g. patient is stable and tolerating enteral feeds)/clinical contraindication	All patients mechanically ventilated (invasive or non-invasive) for >48 h
Feeding	Nutrition goals have been formally assessed and progress reviewed	Yes/No/NA (goals do not need to be assessed or reviewed, e.g. fasting for surgery)	All patients
Glucose	Blood sugar levels (BSL) have been assessed, limits have been set and are being managed to achieve those limits	Yes/No/NA (if clinically appropriate not to monitor frequently)	All patients
Meds	All medications have been checked and reviewed	Yes/No/NA (for auditors only, i.e. unable to determine)	All patients

^aClicking on ‘No’ prompted a ‘Reason for no’ pop-up box which included ‘omission—now corrected’, ‘omission—not yet corrected’ and the other ‘not applicable’ (NA) and ‘clinical contraindication’ responses as outlined in the table.
^bThis question was used to filter out questions that were not applicable to patients who were not invasively ventilated, i.e. if ‘no’ was selected, head-of-bed elevation, readiness to wean and sedation were auto-filled to ‘NA’.

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