Articles: checklist.
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Delirium is a prevalent condition in patients admitted to intensive care units (ICU) associated with worse outcomes. The principal aim of the present study was compare the agreement between two tools for delirium assessment in medical and surgical patients admitted to the ICU. ⋯ The agreement rates between CAM-ICU and ICDSC may vary between different groups of ICU patients and seems to be affected by disease severity.
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Editorial Comment
Why pay for performance may be incompatible with quality improvement.
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The mini-clinical evaluation exercise (mini-CEX) has been proposed as a method to address the deficiencies of in-training assessment for junior doctors. ⋯ There was a significant cost to the ED as a result of adding mini-CEX encounters to interns' performance assessment. No change in summative outcome occurred for this study cohort.
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Unsafe patient transfers are one of the top reasons for incident reporting in hospitals. Criteria guiding safe transfer have been issued by the NHS Litigation Authority. To meet this standard, a "transfer check list" was redesigned for all patients leaving the Acute Medical Unit (AMU) in the Heartlands Hospital. ⋯ After interventions to educate nursing staff and raise awareness of the issues at the regular staff meetings, re-audit demonstrated significant improvement in completion rate. Subsequent monitoring indicates continued improvement, with compliance up to 95% for completion of the transfer checklist on AMU. Incident reporting relating to transfer has also decreased significantly.