reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. carbon dioxide 30 [27][28][29][30][31][32][33][34][35] mmHg and median temperature 37.1 [36.8-37.3]°C. After removal of artefacts, the mean monitoring time was 22 h08 (8 h54). All patients had impaired cerebral autoregulation during their monitoring time. The mean IAR index was 17 (9.5) %. During H 0 H 6 and H 18 H 24 , the majority of our patients; respectively 53 and 71 % had an IAR index > 10 %. Conclusion According to our data, patients with septic shock had impaired cerebral autoregulation within the first 24 hours of their admission in the ICU. In our patients, we described a variability of distribution of impaired autoregulation according to time. ReferencesSchramm P, Klein KU, Falkenberg L, et al. Impaired cerebrovascular autoregulation in patients with severe sepsis and sepsis-associated delirium. Crit Care 2012; 16: R181. Aries MJH, Czosnyka M, Budohoski KP, et al. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit. Care Med. 2012.

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Methods:We planned to complete an audit cycle. Review of guidelines and legislations relevant to medical documentation was conducted to establish a gold standard, which resulted in creation of a questionnaire as audit tool. The answers to the questions were among Yes/No/Not applicable. Ninety case notes were audited against the questionnaire by an auditor and areas of deficiencies were identified. To address those deficiencies using the above-mentioned standards, a Medical Assessment Proforma was constructed and implemented for a prospective trial of 3 months. As a secondary measure and to facilitate clinical handover among all disciplines, a section for ISBAR handover was added to the front page of the proforma. The staff got educated regarding the new proforma. At the end of the trial period, using the original audit tool, another audit was conducted on 90 patients to assess thoroughness of documentation on the new proforma. The results were analysed using a Chi-squared test; the significant level was taken as P < 0.05.OutcomesThe implementation of the admission proforma led to statistically significant improvement in details of the clerking in the following areas: None of the items were more accurately documented prior to implementation of the proforma. There was a 100% compliance with documenting ISBAR handover section on the front cover of the proforma which is expected to improve structured clinical handover. Conclusion:Utilizing a standard medical admission proforma significantly improved overall documentation on admission to the acute medical unit. This is expected to enhance the quality of patient care, decrease medico-legal risks to medical patients, generate more accurate funding for medical units and decrease the risk arising from coding errors. Methods:Centre-based haemodialysis patients from three geographically different kidney units in Queensland, Australia, underwent a single, crosssectional assessment of total daily pill burden from phosphate binders between May 2015 and August 2015. The total number of phosphate binder pills per week comprised of calcium carbonate, aluminium hydroxide, sevelamer hydrochloride, lanthanum and cinacalcet. The urea reduction ratio, serum albumin, serum calcium, serum phosphate and serum parathyroid hormone (PTH) were averaged across this period. Results:Of the 138 patients in this study, 62 (44.9%) patients were from the Royal Brisbane and Women's Hospital (RBWH), 40 (29.0%) patients were from Redcliffe Satellite Unit and 36 (26.1%) patients were from the Northlakes Satellite Unit. Eighty-two (59.4%) were male and the mean age was 66 (standard deviation 15) years. Between hospital comparisons of baseline co-morbidities revealed significant difference in hypertension (P = 0.014) only. Sevelamer hydrochloride was most commonly used at RBWH at 41%, followed by calcium carbonate (32%) and aluminium hydroxide (22%). In contrast, both Northlakes and Redcliffe had similar phosphate binder use with calcium carbonate being most popular (36% and 58% respectively), followed...