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ICU quality and management tools
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<h2 id="icu-quality-tools">ICU quality tools</h2> <p>Quality tools include:<a class="footnote-ref" id="fnref:1" href="#fn:1"><sup>1</sup></a> </p> <ul><li><a href="/facts/Medical_guidelines/l4EfFfa2">Medical guidelines</a>, including <a href="/facts/Checklists/rmyJCY2l">checklists</a><a class="footnote-ref" id="fnref:2" href="#fn:2"><sup>2</sup></a> (items rated as yes/no/not applicable)</li> <li>Templates<a class="footnote-ref" id="fnref:3" href="#fn:3"><sup>3</sup></a> for goal setting or structured communication (a more open format than checklists, templates provide the opportunity to add free text responses with items as prompts)</li> <li>Care bundles, including ABCDE(F) bundle<a class="footnote-ref" id="fnref:4" href="#fn:4"><sup>4</sup></a> (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)</li></ul> <p><a href="/facts/Medical_scoring/VyCyoSmf">Medical scoring</a> systems can be used to describe ICU populations and explain their different outcomes. Examples include: </p> <ul><li><a href="/facts/APACHE_II/ArSsG8hE">APACHE II</a></li> <li><a href="/facts/SAPS_II/Yd4jUwGM">SAPS II</a></li> <li><a href="/facts/SAPS_III/c9I7dtCI">SAPS III</a></li> <li>Mortality Probability Model (MPM)</li></ul> <p>Physical tools include: </p> <ul><li><a href="/facts/Monitoring_(medicine)/cTc3d1j5">Monitoring (medicine)</a>, which may provide data for analysis of ICU performance.</li></ul> <h2 id="icu-management-tools">ICU management tools</h2> <h3>Severity assessment tools</h3> <p>Examples of severity assessment tools:<a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a> </p> <ul><li><a href="/facts/Pneumonia_severity_index/p4wKWKLB">Pneumonia severity index</a> (PSI) or PORT score)</li> <li><a href="/facts/CURB65/lk606uLH">CURB65</a> score</li> <li>CRB65 score</li> <li><a href="/facts/American_Thoracic_Society/47PBehq7">American Thoracic Society</a> (ATS) 2001 criteria</li> <li><a href="/facts/Infectious_Disease_Society_of_America/CjcsK7su">Infectious Disease Society of America</a>/ATS (IDSA/ATS) 2007 criteria</li> <li>Panic Disorder Screener (PADIS) guidelines<a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a></li></ul> <h3>Risk stratification tools</h3> <p>Risk stratification tools examples:<a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a> </p> <ul><li><a href="/facts/Early_warning_score/K9SXn2pG">Early warning score</a> such as the Modified Early Warning Score (MEWS), to predict ICU readmission, and the <a href="/facts/Pediatric_early_warning_signs/198gWNr7">Pediatric early warning signs</a> (PEWS) score</li> <li>Minimizing ICU Readmission (MIR) score,<a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a> to predict patient death or ICU readmission.</li> <li>Sabadell score, which predicts hospital mortality after ICU discharge.</li> <li>Stability and Workload Index for Transfer (SWIFT) score<a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a> and the Frost <a href="/facts/Nomogram/ysXLNuVY">nomogram</a>, to predict ICU readmission.</li></ul> <h2 id="see-also">See also</h2> <ul><li><a href="/facts/APACHE_II/ArSsG8hE">APACHE II</a></li> <li><a href="/facts/SAPS_III/c9I7dtCI">SAPS III</a></li> <li><a href="/facts/Intensive_care_medicine/lbc92jbH">Intensive care medicine</a></li> <li><a href="/facts/Intensive_care_unit/j77VBgtt">Intensive care unit</a></li></ul> <ul><li>Gallesio, Antonio O.; Ceraso, Daniel; Palizas, Fernando (July 2006). "Improving Quality in the Intensive Care Unit Setting". <i>Critical Care Clinics</i>. 22 (3): 547–571. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1016%2Fj.ccc.2006.04.002">10.1016/j.ccc.2006.04.002</a>. <a href="/facts/ISSN_(identifier)/DPAflDvU">ISSN</a> <a href="https://search.worldcat.org/issn/1557-8232">1557-8232</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/16893740">16893740</a>.</li> <li>Garland, Allan (June 2005). "Improving the ICU: part 1". <i>Chest</i>. 127 (6). <a href="/facts/American_College_of_Chest_Physicians/N4pdb3lk">American College of Chest Physicians</a>: 2151–64. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1378%2Fchest.127.6.2151">10.1378/chest.127.6.2151</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/15947333">15947333</a>.</li> <li>Garland, Allan (June 2005). "Improving the ICU: part 2". <i>Chest</i>. 127 (6). <a href="/facts/American_College_of_Chest_Physicians/N4pdb3lk">American College of Chest Physicians</a>: 2165–79. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1378%2Fchest.127.6.2165">10.1378/chest.127.6.2165</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/15947334">15947334</a>.</li> <li>Knaus, William A.; Draper, Elizabeth A.; Wagner, Douglas P.; Zimmerman, Jack E. (October 1985). "APACHE II: a severity of disease classification system". <i>Critical Care Medicine</i>. 13 (10): 818–29. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1097%2F00003246-198510000-00009">10.1097/00003246-198510000-00009</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/3928249">3928249</a>.</li> <li>McMillan, Tracy R.; Hyzy, Robert C. (February 2007). "Bringing quality improvement into the intensive care unit". <i>Critical Care Medicine</i>. 35 (2 Suppl). <a href="/facts/Society_of_Critical_Care_Medicine/Ru4c49sU">Society of Critical Care Medicine</a> and <a href="/facts/Lippincott_Williams_%2526_Wilkins/5kwRHTut">Lippincott Williams & Wilkins</a>: S59 – S65. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1097%2F01.CCM.0000252914.22497.44">10.1097/01.CCM.0000252914.22497.44</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/17242607">17242607</a>.</li> <li>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.</li> <li>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.</li> <li>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.</li></ul> <h2 id="references">References</h2> <h2 id="external-links">External links</h2> <ul><li><a href="https://web.archive.org/web/20090319071651/http://www.mdcalc.com/apache-ii-score-for-icu-mortality">APACHE II Score online</a></li> <li><a href="http://www.saps3.org/resources-downloads/user-agreement/downloads/">SAPS II Scoring Sheets and Database</a></li></ul> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>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. <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Erikson, Ethan J., et al. "The use of checklists in the intensive care unit: a scoping review." Critical Care 27.1 (2023): 468. <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>Iannello, Justin, Nida Waheed, and Patrick Neilan. "Template Design and Analysis: Integrating Informatics Solutions to Improve Clinical Documentation." Federal Practitioner 37.11 (2020): 527. <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li> <li id="fn:4"><p>da Silva Moraes, Fabio, et al. "ABCDE and ABCDEF care bundles: A systematic review protocol of the implementation process in intensive care units." Medicine 98.11 (2019): e14792. <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li> <li id="fn:5"><p>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. <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li> <li id="fn:6"><p>"SCCM | PADIS Guidelines" I. Society of Critical Care Medicine (SCCM). Retrieved 2023-08-15. <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li> <li id="fn:7"><p>Hosein, F. Shaun; Bobrovitz, Niklas; Berthelot, Simon; et al. (29 June 2013). "A systematic review of tools for predicting severe adverse events following patient discharge from intensive care units". Critical Care. 17 (3): R102. doi:10.1186/cc12747. ISSN 1364-8535. PMC 4056089. PMID 23718698. This article incorporates text from this source, which is available under the CC BY 2.0 license. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056089" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056089</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></p></li> <li id="fn:8"><p>Ouanes, Islem, et al. "A model to predict short-term death or readmission after intensive care unit discharge." Journal of critical care 27.4 (2012): 422-e1. <a href="#fnref:8" class="footnote-back-ref">↩</a></p></li> <li id="fn:9"><p>Gajic, Ognjen, et al. "The Stability and Workload Index for Transfer score predicts unplanned intensive care unit patient readmission: initial development and validation." Critical care medicine 36.3 (2008): 676-682. <a href="#fnref:9" class="footnote-back-ref">↩</a></p></li> </ol>