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Title: Compliance with processes of care in intensive care units in Australia and New Zealand - a point prevalence study.
Epworth Authors: Wong, H.
Other Authors: Hewson-Conroy, K.
Burrell, A.
Elliott, David
Webb, S.
Seppelt, I.
Taylor, C.
Glass, P.
Keywords: Epworth Eastern, Arnold Street, Box Hill, Melbourne, Victoria, Australia.
Intensive Care Units
Patient Care Management
Acute Physiology and Chronic Health Evaluation
Nursing Care Management
Standards of Care
Process Assessment (Health Care)
Assessment, Process
Best Practices
Critical Care
Quality Indicators, Health Care
Delivery of Health Care
Healthcare Delivery
Issue Date: Sep-2011
Publisher: Elsevier
Citation: Anaesthesia and Intensive Care. 2011 Sep;39(5):926-35.
Abstract: There are indications that compliance with routine clinical practices in intensive care units (ICU) varies widely internationally, but it is currently unknown whether this is the case throughout Australia and New Zealand. A one-day point prevalence study measured the prevalence of routine care processes being delivered in Australian and New Zealand ICUs including the assessment and/or management of: nutrition, pain, sedation, weaning from mechanical ventilation, head of bed elevation, deep venous thrombosis prophylaxis, stress ulcer prophylaxis, blood glucose, pressure areas and bowel action. Using a sample of 50 adult ICUs, prevalence data were collected for 662 patients with a median age of 65 years and a median Acute Physiology and Chronic Health Evaluation II score of 18. Wide variations in compliance were evident in several care components including: assessment of nutritional goals (74%, interquartile range [IQR] 51 to 89%), pain score (35%, IQR 17 to 62%), sedation score (89%, IQR 50 to 100%); care of ventilated patients e.g. head of bed elevation > 30 degrees (33%, IQR 7 to 62%) and setting weaning plans (50%, IQR 28 to 78%); pressure area risk assessment (78%, IQR 18 to 100%) and constipation management plan (43%, IQR 6 to 87%). Care components that were delivered more consistently included nutrition delivery (100%, IQR 100 to 100%), deep venous thrombosis (96%, IQR 89 to 100%) and stress ulcer (90%, IQR 78 to 100%) prophylaxis, and checking blood sugar levels (93%, IQR 88 to 100%). This point prevalence study demonstrated variability in the delivery of 'routine' cares in Australian and New Zealand ICUs. This may be driven in part by lack of consensus on what is best practice in intensive care units, prompting the need for further research in this area.
Description: Contribution to data for study from H. Wong @ Epworth Eastern
PubMed URL:
ISSN: 1472-0299
Journal Title: Anaesthesia and Intensive Care
Type: Journal Article
Affiliated Organisations: New South Wales Intensive Care Coordination and Monitoring Unit, Penrith, New South Wales, Australia.
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Critical Care
Health Administration

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