A Survey of Rounding Practices in Canadian Adult Intensive Care UnitsReport as inadecuate




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Objective

To describe rounding practices in Canadian adult Intensive Care Units ICU and identify opportunities for improvement.

Design

Mixed methods design. Cross sectional survey of Canadian Adult ICUs n = 180 with purposefully sampled follow-up interviews n = 7.

Measurements and Main Results

Medical directors representing 111 ICUs 62% participated in the survey. Rounding practices varied across ICUs with the majority reporting the use of interprofessional rounds 81% that employed an open 94% and collaborative 86% approach, occurred at the patient’s bedside 82%, and started at a standard time 79% and standard location 56%. Most participants reported that patients 83% and family members 67% were welcome to attend rounds. Approximately half of ICUs 48% used tools to facilitate rounds. Interruptions during rounds were reported to be common i.e., ≥1 interruption for ≥50% of patients in 46% of ICUs. Four themes were identified from qualitative analysis of participant responses to open-ended survey questions and interviews: multidisciplinarity, patient and family involvement, factors influencing productivity, and teaching and learning.

Conclusions

There is considerable variation in current rounding practices in Canadian medical-surgical ICUs. Opportunities exist to improve ICU rounds including ensuring the engagement of essential participants, clearly defining participant roles, establishing a standardized approach to the rounding process, minimizing interruptions, modifying the role of teaching, utilizing a structured rounding tool, and developing a metric for measuring rounding quality.



Author: Jessalyn K. Holodinsky, Marilynne A. Hebert, David A. Zygun, Romain Rigal, Simon Berthelot, Deborah J. Cook, Henry T. Stelfox

Source: http://plos.srce.hr/



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