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Boarding ICU patients: Are our rounding practices subpar?

Authors :
Patrick M. Reilly
Niels D. Martin
Lewis J. Kaplan
Brian P. Smith
Mark J. Seamon
Daniel N. Holena
Andrew M. Nunn
Justin S. Hatchimonji
C. William Schwab
Jose L. Pascual
Source :
American journal of surgery. 215(4)
Publication Year :
2017

Abstract

Introduction Surgical Intensive Care Unit (SICU) patients “boarding” in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs. Material and methods SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded. Multivariable regression analysis was used for comparison between patients. Results Non-boarders were older, observed on a later post ICU admission day and were more likely to be mechanically ventilated. Boarded patients were often seen at the end of rounds and for less time. Not being a boarder, age, APACHE II score on admission, vasopressor use, and positive pressure ventilation all predicted increased rounding time. Conclusions Surgical ICU patients boarding in non-preferred units are often seen at the end of rounds, result in a greater reliance upon telephone communication, and receive less bedside attention from ICU provider teams.

Details

ISSN :
18791883
Volume :
215
Issue :
4
Database :
OpenAIRE
Journal :
American journal of surgery
Accession number :
edsair.doi.dedup.....4fad36dd44e85808f52a88f08c088e45