An Electronic Tool for Visual Feedback to Monitor the Adherence to Quality Indicators in Intensive Care Medicine

被引：15
作者：
Kastrup, M. [1 ]
Nolting, M. J. [1 ]
Ahlborn, R. [2 ]
Braun, J-P [1 ]
Grubitzsch, H. [3 ]
Wernecke, K-D [4 ]
Spies, C. [1 ]
机构：
[1] Charite, Dept Anesthesiol & Intens Care Med, D-13353 Berlin, Germany
[2] Charite, IT Dept, D-13353 Berlin, Germany
[3] Charite, Dept Cardiovasc Surg, D-13353 Berlin, Germany
[4] Sostana GmbH, Berlin, Germany
来源：
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH | 2011年 / 39卷 / 06期
关键词：
KEY PERFORMANCE INDICATORS; FEEDBACK; CRITICAL CARE; ICU; OUTCOME; MORTALITY; QUALITY IMPROVEMENT; GUIDELINE IMPLEMENTATION; CLINICAL-PRACTICE GUIDELINES; CRITICALLY-ILL PATIENTS; MECHANICAL VENTILATION; WEANING PROTOCOL; EXCESS MORTALITY; CONTROLLED-TRIAL; HEALTH-CARE; UNIT; SEDATION; IMPROVEMENT;
D O I：
10.1177/147323001103900615
中图分类号：
R-3 [医学研究方法]; R3 [基础医学];
学科分类号：
1001 ;
摘要：
Evidence-based medicine is often inadequately implemented in intensive care units (ICU); the aim of this study was to improve its implementation via a technical feedback system, using key performance indicators (KPI). The study evaluated 205 patients treated in a cardiac surgical ICU over a 6-month period (3 months before and 3 months after implementation of the feedback system). KPI adherence rates for sedation, delirium and pain monitoring, and completion of a weaning protocol before and after the implementation of the feedback system, were compared. Adherence rates for pain and delirium monitoring, and implementation of the weaning protocol, were significantly increased by the intervention. Adherence to KPIs for sedation, which were high at baseline, could not be further improved. Daily display of KPI implementation had a positive effect on adherence to standard operating procedures. Adherence to guidelines may be improved by using this feedback system as part of the clinical routine.
引用
收藏
页码：2187 / 2200
页数：14
相关论文
共 55 条
  • [21] Toward improved implementation of evidence-based clinical algorithms: Clinical practice guidelines, clinical decision rules, and clinical pathways
    Gaddis, Gary M.
    Greenwald, Peter
    Huckson, Sue
    [J]. ACADEMIC EMERGENCY MEDICINE, 2007, 14 (11) : 1015 - 1022
  • [22] Improving the ICU - Part 2
    Garland, A
    [J]. CHEST, 2005, 127 (06) : 2165 - 2179
  • [23] Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial
    Girard, Timothy D.
    Kress, John P.
    Fuchs, Barry D.
    Thomason, Jason W. W.
    Schweickert, William D.
    Pun, Brenda T.
    Taichman, Darren B.
    Dunn, Jan G.
    Pohlman, Anne S.
    Kinniry, Paul A.
    Jackson, James C.
    Canonico, Angelo E.
    Light, Richard W.
    Shintani, Ayumi K.
    Thompson, Jennifer L.
    Gordon, Sharon M.
    Hall, Jesse B.
    Dittus, Robert S.
    Bernard, Gordon R.
    Ely, E. Wesley
    [J]. LANCET, 2008, 371 (9607) : 126 - 134
  • [24] Grimshaw J, 2006, J GEN INTERN MED, V21, pS14, DOI 10.1111/j.1525-1497.2006.00357.x
  • [25] Winter excess mortality in intensive care in the UK: an analysis of outcome adjusted for patient case mix and unit workload
    Harrison, DA
    Lertsithichai, P
    Brady, AR
    Carpenter, JR
    Rowan, K
    [J]. INTENSIVE CARE MEDICINE, 2004, 30 (10) : 1900 - 1907
  • [26] Audit and feedback and clinical practice guideline adherence: Making feedback actionable
    Hysong, Sylvia J.
    Best, Richard G.
    Pugh, Jacqueline A.
    [J]. IMPLEMENTATION SCIENCE, 2006, 1 (1)
  • [27] Long-term Cognitive and Psychological Outcomes in the Awakening and Breathing Controlled Trial
    Jackson, James C.
    Girard, Timothy D.
    Gordon, Sharon M.
    Thompson, Jennifer L.
    Shintani, Ayumi K.
    Thomason, Jason W. W.
    Pun, Brenda T.
    Canonico, Angelo E.
    Dunn, Janet G.
    Bernard, Gordon R.
    Dittus, Robert S.
    Ely, E. Wesley
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2010, 182 (02) : 183 - 191
  • [28] Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult
    Jacobi, J
    Fraser, GL
    Coursin, DB
    Riker, RR
    Fontaine, D
    Wittbrodt, ET
    Chalfin, DB
    Masica, MF
    Bjerke, HS
    Coplin, WM
    Crippen, DW
    Fuchs, BD
    Kelleher, RM
    Marik, PE
    Nasraway, SA
    Murray, MJ
    Peruzzi, WT
    Lumb, PD
    [J]. CRITICAL CARE MEDICINE, 2002, 30 (01) : 119 - 141
  • [29] Jamtvedt G., 2006, Cochrane Database of Syst Rev, V2, P000259, DOI DOI 10.1002/14651858.CD000259.PUB2
  • [30] Identifying and implementing quality improvement measures in the intensive care unit
    Kahn, Jeremy M.
    Fuchs, Barry D.
    [J]. CURRENT OPINION IN CRITICAL CARE, 2007, 13 (06) : 709 - 713
123456