Appraisal of the daily clinical rounds performed in an open and general ICU
© Filho et al. 2015
Published: 28 September 2015
Daily multidisciplinary clinical rounds involving physicians, nurses, respiratory therapists, nutritionists and clinical pharmacists improve the quality and outcomes of ICUs . However, data regarding performance of these clinical rounds in an open-ICU model are limited.
To address the characteristics and the main interventions proposed and made during multiprofessional clinical rounds performed in a clinical-surgical open ICU.
This observational study was conducted in a 41-bed open clinical-surgical ICU of a tertiary-care, private hospital in São Paulo, Brazil. From February 20 through March 28 2013, demographic data, SAPS 3, the participants of the ICU clinical rounds, the number and type of the proposed interventions, and the number of performed interventions by the multidisciplinary team were recorded and analyzed.
A total of 158 clinical rounds were included in this analysis. Fifty-four percent (85/158) of the patients were male with median (IQR) age of 73 (60-84) years and SAPS 3 score of 52 (44-65). The multidisciplinary team was composed of a senior physician (157/158 (99%)), nurses (157/158 (99%)), an on-call staff physician (150/158 (95%)), respiratory therapists (149/158 (94%)), a clinical pharmacist (89/158 (56%)) and nutritionists (62/158 (39.2%)). The median (IQR) number of interventions proposed during the multidisciplinary rounds was 1 (0-2) and the number of performed interventions was 1 (0-2) (Table 1). Interventions were more frequently proposed by senior physicians (82/158 (52%)) followed by respiratory physiotherapists (43/158 (27%)) and a clinical pharmacist (29/158 (18%)).
Main interventions proposed and performed during the multiprofessional rounds.
Changes in nutritional support
Adjustments on sedation or analgesia
Withdrawal of invasive devices
Adjustments of ventilatory parameters
Adjustments on glycemic control
Deep vein thrombosis prophylaxis
Stress ulcer prophylaxis
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