Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools

Allum, Laura; Apps, Chloe; Pattison, Natalie; Connolly, Bronwen; Rose, Louise

doi:10.1016/j.iccn.2022.103302

Cited by 7 publications

(3 citation statements)

References 116 publications

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“…A strength of our study is the involvement of ICU survivors and family members throughout item generation and consensus building stages. In a recent scoping review conducted by our group [21], only two of 68 studies (3%) describing quality improvement tools for use in ICU reported involvement of patients and family members in tool development. In our study, actionable processes uniquely identified by patient and family participants focused on aspects of care they recalled as particularly distressing such as the use of physical restraint, having trouble clearing secretions, and feeling lonely, bored, and wanting to return to normality.…”

Section: Discussionmentioning

confidence: 99%

Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness

Rose

Istanboulian

Amaral

et al. 2022

Journal of Critical Care

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Section: Discussionmentioning

confidence: 99%

Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness

Rose

Istanboulian

Amaral

et al. 2022

Journal of Critical Care

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“…To our knowledge, this is the first published scoping review on the use and efficacy of checklists within the ICU but other reviews on related topics have previously been published [9,10,[41][42][43][44][45][46][47][48][49]. We identified one other scoping review on quality improvement tools for the nursing care of long stay patients in the ICU [41]. Ten systematic reviews on specific checklists have been published since 2012 [9,10,[42][43][44][45][46][47][48][49].…”

Section: Ics and Ficm Percutaneous Tracheostomy Checklist [30] Yesmentioning

confidence: 99%

The use of checklists in the intensive care unit: a scoping review

Erikson,

Edelman,

Brewster

et al. 2023

Crit Care

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Background Despite the extensive volume of research published on checklists in the intensive care unit (ICU), no review has been published on the broader role of checklists within the intensive care unit, their implementation and validation, and the recommended clinical context for their use. Accordingly, a scoping review was necessary to map the current literature and to guide future research on intensive care checklists. This review focuses on what checklists are currently used, how they are used, process of checklist development and implementation, and outcomes associated with checklist use. Methods A systematic search of MEDLINE (Ovid), Embase, Scopus, and Google Scholar databases was conducted, followed by a grey literature search. The abstracts of the identified studies were screened. Full texts of relevant articles were reviewed, and the references of included studies were subsequently screened for additional relevant articles. Details of the study characteristics, study design, checklist intervention, and outcomes were extracted. Results Our search yielded 2046 studies, of which 167 were selected for further analysis. Checklists identified in these studies were categorised into the following types: rounding checklists; delirium screening checklists; transfer and handover checklists; central line-associated bloodstream infection (CLABSI) prevention checklists; airway management checklists; and other. Of 72 significant clinical outcomes reported, 65 were positive, five were negative, and two were mixed. Of 122 significant process of care outcomes reported, 114 were positive and eight were negative. Conclusions Checklists are commonly used in the intensive care unit and appear in many clinical guidelines. Delirium screening checklists and rounding checklists are well implemented and validated in the literature. Clinical and process of care outcomes associated with checklist use are predominantly positive. Future research on checklists in the intensive care unit should focus on establishing clinical guidelines for checklist types and processes for ongoing modification and improvements using post-intervention data.

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“…There is a lack of quality improvement tools to inform the care of patients with P/CCI. Existing measures of ICU care quality and tools such as checklists are not sufficiently inclusive of actionable processes of care relevant to patients experiencing P/CCI nor have they been developed with patient and family input (Allum et al., 2022). A better understanding is therefore needed among ICU decision‐makers about how to best deliver and organize processes to enable high‐quality patient and family‐focused care for P/CCI patients and their family members.…”

Section: Introductionmentioning

confidence: 99%

Clinician‐perceived barriers and facilitators for the provision of actionable processes of care important for persistent or chronic critical illness

Istanboulian,

Dale,

Terblanche

et al. 2023

Journal of Advanced Nursing

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AimTo explore clinician‐perceived barriers to and facilitators for the provision of actionable processes of care important for patients with persistent or chronic critical illness.DesignQualitative descriptive interview study.MethodsSecondary analysis of semi‐structured telephone interviews (December 2018 – February 2019) with professionally diverse clinicians working with adults experiencing persistent or chronic critical illness in Canadian intensive care units. We used deductive content analysis informed by the Social‐Ecological Model.ResultsWe recruited 31 participants from intensive care units across nine Canadian provinces. Reported intrapersonal level barriers to the provision of actionable processes of care included lack of training, negative emotions and challenges prioritizing these patients. Facilitators included establishment of positive relations and trust with patients and family. Interpersonal barriers included communication difficulties, limited access to physicians and conflict. Facilitators included communication support, time spent with the patient/family and conflict management. Institutional barriers comprised inappropriate care processes, inadequate resources and disruptive environmental conditions. Facilitators were regular team rounds, appropriate staffing and employment of a primary care (nurse and/or physician) model. Community‐level barriers included inappropriate care location and insufficient transition support. Facilitators were accessed to alternate care sites/teams and to formalized transition support. Public policy‐level barriers included inadequacy of formal education programs for the care of these patients; knowledge implementation for patient management was identified as a facilitator.ConclusionOur results highlighted multilevel barriers and facilitators to the delivery of actionable processes important for quality care for patient/family experiencing persistent or chronic critical illness.ImpactUsing the Social‐Ecological Model, the results of this study provide intra and interpersonal, institutional, community and policy‐level barriers to address and facilitators to harness to improve the care of patients/family experiencing persistent or chronic critical illness.Reporting MethodConsolidated criteria for reporting qualitative studies.Patient or Public ContributionNo patient or public contribution.

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Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools

Cited by 7 publications

References 116 publications

Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness

Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness

The use of checklists in the intensive care unit: a scoping review

Clinician‐perceived barriers and facilitators for the provision of actionable processes of care important for persistent or chronic critical illness

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