The use of a checklist to guide multidisciplinary rounds improves the utilization of prophylactic and safety actions in a closed intensive care unit

Background

Checklist forms have been successfully used during multidisciplinary rounds in an 'open' ICU to increase the use of prophylactic and risk reduction interventions.

Objective

To evaluate the benefits of using a checklist form in a 'closed' ICU to increase the utilization of prophylactic and safety interventions.

Methods

The data of the head of bed position, peak inspiratory pressure during mechanical ventilation, deep vein thrombosis and digestive bleeding prophylaxis were recorded for 2 weeks before (n = 93 cases) and after (n = 72) the implementation of a checklist (modified from [1]) to guide the multidisciplinary visit in the morning, noon, and night in a high-complexity (22 medical/surgical beds) 'closed' ICU.

Results

The percentage of patients with head bed position > 30° (49% vs 77%, P < 0.001) and the use of deep vein thrombosis prophylaxis (61% vs 82%, P < 0.001) increased after the use of the checklist during the rounds. Digestive bleeding prophylaxis (93%) and limiting the peak inspiratory pressure < 35 cmH₂O (90%) were observed in almost all patients in the pre-checklist period and this intervention did not increase their utilization (94% vs 90%, respectively, P = 0.6).

Conclusion

As previously demonstrated in 'open' ICUs, using a checklist to guide the multidisciplinary rounds is helpful to increase the utilization of prophylactic and safety interventions in a 'closed' ICU.