Articles: checklist.
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Critical care medicine is at a crossroads in which limited numbers of staff care for increasing numbers of patients as the population ages and use of ICUs increases. Also at this time health care spending must be curbed. ⋯ When implemented correctly and in the right populations this technology has improved outcomes. Future studies regarding implementation, organization, staffing, and innovation are needed to determine the optimal use of this critical care professional enhanced technology.
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Journal of critical care · Apr 2015
Randomized Controlled TrialThe effectiveness of an intensive care quick reference checklist manual-A randomized simulation-based trial.
We aimed to test the effectiveness of checklists for emergency procedures on medical staff performance in intensive care crises. ⋯ Use of checklists in ICU crises has a benefit on the completion of critical treatment steps. Within the type 2 scenarios, items were fulfilled faster with checklists. The implementation of checklists for intensive care crises is a promising approach that may improve patients' care.
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Improving patient safety seems to be a new interesting clinical subject but, in fact, it is no new. It has to do with one of the oldest ethical principles of our profession: curing and not harming. The important research that has been done in a short period of time has brought in new insight to this complex area that is fast developing. ⋯ More complex and detail checklist can be more adequate for more complex procedures and settings. The proposed ESTS checklist reviews different areas of possible error in deeper detail allowing the finest adjustment of the patient before the skin incision. It has been recently released to the general thoracic community and monitors its use and usefulness has to be warrantied.
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Pediatric emergency care · Apr 2015
Observational StudyA Novel Briefing Checklist at Shift Handoff in an Emergency Department Improves Situational Awareness and Safety Event Identification.
Emergency department (ED) shift handoffs are sources of potential medical error, delays in care, and medicolegal liabilities. Few handoff studies exist in the ED literature. We aimed to describe the implementation of a standardized checklist for improving situational awareness during physician handoffs in a pediatric ED. ⋯ The Physician Active Shift Signout in the Emergency Department briefing checklist was used often and at a high completion rate, frequently identifying potential safety events. The users found that it improved the quality of care and team communication. Future studies on outcomes and processes are needed.
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Checklist utilization has been shown to improve multiple processes of care in the intensive care unit (ICU). The ICU setting makes checklist implementation challenging, particularly when prompters are unavailable to ensure checklist compliance. We performed a prospective analysis on physician compliance reporting as a means to improve attending physician compliance with checklist use during ICU rounds. ⋯ Physician compliance reporting can be used to improve ICU physician compliance with rounding checklists when prompters are unavailable. Improved physician compliance translated into decreased rates of Foley catheter, central venous catheter, and ventilator use. These results highlight the impact physician accountability can have on patient care in the ICU.