The Surgical Intensive Care Unit Family Experience Survey: Integrating the Patient/Family Perspective Into ICU Quality Improvement

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 478A
Author(s):  
Bridget Twohig ◽  
David Eshak ◽  
Adel Bassily Marcus ◽  
Anthony Manasia ◽  
John Oropello ◽  
...  
2015 ◽  
Vol 28 (4) ◽  
pp. 281-284 ◽  
Author(s):  
Bridget Twohig ◽  
Anthony Manasia ◽  
Adel Bassily-Marcus ◽  
John Oropello ◽  
Matthew Gayton ◽  
...  

2021 ◽  
Vol 41 (2) ◽  
pp. 16-26
Author(s):  
Angela Bonomo ◽  
Diane Lynn Blume ◽  
Katie Davis ◽  
Hee Jun Kim

Background At least 80% of ordered enteral nutrition should be delivered to improve outcomes in critical care patients. However, these patients typically receive 60% to 70% of ordered enteral nutrition volume. In a practice review within a 28-bed medical-surgical adult intensive care unit, patients received a median of 67.5% of ordered enteral nutrition with standard rate-based feeding. Volume-based feeding is recommended to deliver adequate enteral nutrition to critically ill patients. Objective To use a quality improvement project to increase the volume of enteral nutrition delivered in the medical-surgical intensive care unit. Methods Percentages of target volume achieved were monitored in 73 patients. Comparisons between the rate-based and volume-based feeding groups used nonparametric quality of medians test or the χ2 test. A customized volume-based feeding protocol and order set were created according to published protocols and then implemented. Standardized education included lecture, demonstration, written material, and active personal involvement, followed by a scenario-based test to apply learning. Results Immediately after implementation of this practice change, delivered enteral nutrition volume increased, resulting in a median delivery of 99.8% of ordered volume (P = .003). Delivery of a mean of 98% ordered volume was sustained over the 15 months following implementation. Conclusions Implementation of volume-based feeding optimized enteral nutrition delivery to critically ill patients in this medical-surgical intensive care unit. This success can be attributed to a comprehensive, individualized, and proactive process design and educational approach. The process can be adapted to quality improvement initiatives with other patient populations and units.


2015 ◽  
Author(s):  
Mark R. Hemmila ◽  
Wendy L Wahl

Programs to support clinical benchmarking of surgical outcomes have grown dramatically over the past decade. Selection of an appropriate project and preplanning with regard to strategy are often more important than management skill alone when undertaking and performing successful quality improvement in the intensive care unit (ICU) setting. This review covers an overview of a medical and surgical quality system, development of an ICU quality improvement program, scoring systems: risk assessment, evidence-based medicine and protocols, and a quality improvement framework. Figures show structure of the ICU quality improvement team, the C-index statistic reflecting the ability of a model to predict which patients will have the outcome of interest, a Shewhart statistical process control chart, venous thromboembolism (VTE) events by report number, and changes in the type of VTE prophylaxis agent administered over time.  Tables list Blue Cross Blue Shield of Michigan/Blue Care Network-sponsored, registry-based collaborative quality initiatives, critical care societies’ collaborative-based quality improvement task force priorities for performance measurement, possible ICU quality measures, predictive scoring systems, and multivariate and propensity score analysis of the Michigan Trauma Quality Improvement Program pilot data for VTE events and type of VTE prophylaxis.   This review contains 5 highly rendered figures, 5 tables, and 59 references


2009 ◽  
Vol 18 (1) ◽  
pp. 58-64 ◽  
Author(s):  
L. Donahoe ◽  
E. McDonald ◽  
M. E. Kho ◽  
M. Maclennan ◽  
P. W. Stratford ◽  
...  

2010 ◽  
Vol 36 (11) ◽  
pp. 1890-1898 ◽  
Author(s):  
Michelle R. Ananda-Rajah ◽  
Emma S. McBryde ◽  
Kirsty L. Buising ◽  
Leanne Redl ◽  
Christopher MacIsaac ◽  
...  

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