Bendigo Health ICU Manual
  • Home
  • Administration
    • Team members
    • Roles & Responsibilities at a Glance
    • ICU Orientation Guide 2018 >
      • Unit description: contacts, details and nursing support
      • Duty hours: roster, leave
      • Roles & Expectations: Duty registrar and Outreach registrar
      • Ward round duties
      • Ongoing patient management: prescribing, investigations
      • Documentation and preparation for Admission & Transfers
      • Referrals & Refusals
      • Lines of reporting and division of responsibiities: ICU, CCU, paediatric ICU
      • Night Huddle
      • MET calls
      • Deaths in iCU
      • Morbidity & Mortality meeting preparation
      • Procedures
      • Intubation
      • Education & Learning opportunities
      • HMO Learning Objectives
      • Research
      • Infection Control
      • Resources, policies & guidelines
      • Dress code
      • Mentors
      • Phones & Pagers
      • National Safety and Quality Health Service Standards
      • Unit Guide: Feedback & Disclaimers
    • ICU ROVER 2017 >
      • Introduction
      • Unit description and Key Contacts
      • HMO Schedule: ward rounds and handovers
      • HMO responsibilities: admissions & discharges
      • Rostering & Education
      • Common medical conditions managed in ICU
      • Useful resources
      • Basic rules
    • ICU Consultant Orientation Guide >
      • 1.1. - 1.2. Structure of Bendigo Health
      • 2.1 Administration in ICU
      • 2.2. Clinical >
        • 2.2. Clinical (introduction)
        • 2.2.1. Referrals
        • 2.2.2. Admission paperwork
        • 2.2.3. Discharges
        • 2.2.4. Deaths in ICU
        • 2.2.5. External transfers
        • 2.2.6. St John of God ICU (SJOG)
      • 2.3. Structure of the day
      • 2.4. Interface with other units
      • 2.5. Clinical Management (introduction) >
        • 2.5. Clinical Management (introduction)
        • 2.5.1. Respiratory
        • 2.5.2. Cardiovascular
        • 2.5.3. Renal / CRRT
        • 2.5.4. Nutrition
        • 2.5.5. Endocrine
        • 2.5.6. Infection and antimicrobials
        • 2.5.7. Care bundles
        • 2.5.8. Resuscitation and Advanced Care Planning
        • 2.5.9. Analgesia
      • 2.6. Outreach
      • 2.7. Follow up clinic
      • 2.8. Non-clinical expectations >
        • 2.8. Non-clinical expectations (introduction)
        • 2.8.1. Mandatory competencies
        • 2.8.2. Professional Development Reviews (PDRs)
    • Echuca Telehealth Consults
    • Orientation & Guides (downloadable versions)
    • ICU Orientation Presentation 2018
    • Shift swap form for consultants
    • VHIMS >
      • VHIMS Resources (intranet only)
      • How to enter a VHIMS (intranet only)
    • Social Media Etiquette
    • Useful contacts
  • Clinical
    • Admissions & Discharges >
      • Admissions & Discharges
      • Guideline to Surgical Admissions
    • Daily ICU review & care >
      • FAST HUGS IN BED PLEASE
      • Oxygen prescribing
      • Oxygen - Paediatric considerations
      • Care of the Invasively Ventilated Patient – Adult Patient (PROMPT)
      • Assessing for extubation
      • Nutrition in ICU
      • Thiamine prescribing
      • Patient Diaries
    • Drugs & Infusions >
      • Inpatient prescribing practices
      • Common ICU Drugs
      • Drug Infusions A-Z
      • Drugs by system/action >
        • Antibiotics
        • Diuretics
        • Antithrombotic therapy
        • Analgesics in ICU
        • Antipyretic
        • Anticonvulsants
        • Antiplatelets
        • Antihypertensives
        • Beta-blockers
        • Neuromuscular Blocking Agents
        • Aperients / Laxatives
        • Prokinetics
    • Care bundle >
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols >
      • Stroke Protocol (SCV Oct 2018)
    • NIV >
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
    • CRRT
    • Procedures
    • Care of the Dying Patient
    • Emergency calls to the helicopter pad
    • Transferring ICU patients >
      • Intra & Interhospital transfers
      • MRI transfers - special considerations
    • Organ & Tissue Donation
    • Welfare & other supports for patients and family >
      • Visiting times
      • Social work, pastoral care & aboriginal hospital liaison officer support
      • Interpreter services
      • Patient relations office
    • PROMPT
  • Professional development
    • Education & Training >
      • Learning and Training in ICU
      • ICU Education Curriculum
      • CICM Primary Exam education
    • Assessments, logbooks and mandatory training >
      • Procedures competency assessments / Logbook
      • Registrar Assessments and In-Training Evaluation Reports (ITERs)
      • Mandatory training for medical staff
    • Echocardiography in ICU
    • Crit-IQ
    • Other education opportunities
    • Mentorship
    • Looking after yourself and colleagues
    • BASIC Provider course
    • Paediatric BASIC provider course
    • Paediatric crit care education
    • Useful links and resources
  • Research/QI
    • Research >
      • STARRT AKI
      • SuDDICU
      • PLUS study
      • Recent Publications
    • Quality & Safety Audits >
      • Procedure database
      • NEAT Audit
      • ICU Discharge Audit
      • Documentation Audit
    • Administration for the ICU Procedural Database
  • Paediatric ICU
    • Introduction
    • PIPER Paediatric GO NOW Criteria
    • Criteria for admission of children to a regional hospital ICU or a paediatric ward HDU
    • Common Paediatric Conditions (SCV Guidelines) >
      • Asthma
      • Bronchiolitis >
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis
      • Seizures >
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child >
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
    • Paediatric Crit Care Education >
      • ED/Paeds education sessions
      • Other paediatric crit care education opportunities
    • Paediatric Resus Card
  • Emergency!
    • Code Blue: ALS algorithms >
      • Adult ALS algorithm
      • Paediatric ALS algorithm
      • Obstetric cardiac arrest flowchart
    • Emergency algorithms/mnemonics >
      • Airway
      • Breathing
      • Circulation >
        • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
      • Disability
    • MET calls: common scenarios >
      • Staff concern
      • The Dying Patient
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Oliguria/Anuria
    • MET calls: resources
    • Paediatric Resus Card

NEAT - Audit of ICU admission practices from ED

Who       
50 patients admitted from ED to ICU


How       
NEAT data collection form completed by duty registrar at time of ICU admission 

https://docs.google.com/forms/d/1uzd1CENtc-PYgYhR-201FtoBxO0Kv8T1YoqDb4AccG0/edit?usp=forms_home&ths=true

When     
6 monthly


Why       
To identify preventable systemic delays in patients being admitted to ICU from ED. In critically ill patients, there is a clear association between the length of time spent in ED and an increase in mortality rates.


Reporting    
At the completion of each audit, the ICU registrar will-
  1. Report to the ICU morbidity and mortality meeting
  2. Provide a written report 
  3. Recommend any changes to the audit including data collection and reported outcomes

Outcomes    
Quantitative
  1. Median time between –
    1. Triage and ICU referral  
    2. Initial review by ED doctor and ICU referral  
    3. ICU referral time and ICU review  
    4. ICU review and ICU acceptance
    5. ICU acceptance and ED departure or ICU arrival
  2. Proportion of admissions that required patient discharge(s) from ICU to create capacity 
  3. Number of patients needing discharge from ICU
  4. whether the ACCESS nurse was subsequently needed for direct patient care
Qualitative 
    1. Reasons for admission delays (such as procedures, imaging, patient deterioration etc)
  • Home
  • Administration
    • Team members
    • Roles & Responsibilities at a Glance
    • ICU Orientation Guide 2018 >
      • Unit description: contacts, details and nursing support
      • Duty hours: roster, leave
      • Roles & Expectations: Duty registrar and Outreach registrar
      • Ward round duties
      • Ongoing patient management: prescribing, investigations
      • Documentation and preparation for Admission & Transfers
      • Referrals & Refusals
      • Lines of reporting and division of responsibiities: ICU, CCU, paediatric ICU
      • Night Huddle
      • MET calls
      • Deaths in iCU
      • Morbidity & Mortality meeting preparation
      • Procedures
      • Intubation
      • Education & Learning opportunities
      • HMO Learning Objectives
      • Research
      • Infection Control
      • Resources, policies & guidelines
      • Dress code
      • Mentors
      • Phones & Pagers
      • National Safety and Quality Health Service Standards
      • Unit Guide: Feedback & Disclaimers
    • ICU ROVER 2017 >
      • Introduction
      • Unit description and Key Contacts
      • HMO Schedule: ward rounds and handovers
      • HMO responsibilities: admissions & discharges
      • Rostering & Education
      • Common medical conditions managed in ICU
      • Useful resources
      • Basic rules
    • ICU Consultant Orientation Guide >
      • 1.1. - 1.2. Structure of Bendigo Health
      • 2.1 Administration in ICU
      • 2.2. Clinical >
        • 2.2. Clinical (introduction)
        • 2.2.1. Referrals
        • 2.2.2. Admission paperwork
        • 2.2.3. Discharges
        • 2.2.4. Deaths in ICU
        • 2.2.5. External transfers
        • 2.2.6. St John of God ICU (SJOG)
      • 2.3. Structure of the day
      • 2.4. Interface with other units
      • 2.5. Clinical Management (introduction) >
        • 2.5. Clinical Management (introduction)
        • 2.5.1. Respiratory
        • 2.5.2. Cardiovascular
        • 2.5.3. Renal / CRRT
        • 2.5.4. Nutrition
        • 2.5.5. Endocrine
        • 2.5.6. Infection and antimicrobials
        • 2.5.7. Care bundles
        • 2.5.8. Resuscitation and Advanced Care Planning
        • 2.5.9. Analgesia
      • 2.6. Outreach
      • 2.7. Follow up clinic
      • 2.8. Non-clinical expectations >
        • 2.8. Non-clinical expectations (introduction)
        • 2.8.1. Mandatory competencies
        • 2.8.2. Professional Development Reviews (PDRs)
    • Echuca Telehealth Consults
    • Orientation & Guides (downloadable versions)
    • ICU Orientation Presentation 2018
    • Shift swap form for consultants
    • VHIMS >
      • VHIMS Resources (intranet only)
      • How to enter a VHIMS (intranet only)
    • Social Media Etiquette
    • Useful contacts
  • Clinical
    • Admissions & Discharges >
      • Admissions & Discharges
      • Guideline to Surgical Admissions
    • Daily ICU review & care >
      • FAST HUGS IN BED PLEASE
      • Oxygen prescribing
      • Oxygen - Paediatric considerations
      • Care of the Invasively Ventilated Patient – Adult Patient (PROMPT)
      • Assessing for extubation
      • Nutrition in ICU
      • Thiamine prescribing
      • Patient Diaries
    • Drugs & Infusions >
      • Inpatient prescribing practices
      • Common ICU Drugs
      • Drug Infusions A-Z
      • Drugs by system/action >
        • Antibiotics
        • Diuretics
        • Antithrombotic therapy
        • Analgesics in ICU
        • Antipyretic
        • Anticonvulsants
        • Antiplatelets
        • Antihypertensives
        • Beta-blockers
        • Neuromuscular Blocking Agents
        • Aperients / Laxatives
        • Prokinetics
    • Care bundle >
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols >
      • Stroke Protocol (SCV Oct 2018)
    • NIV >
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
    • CRRT
    • Procedures
    • Care of the Dying Patient
    • Emergency calls to the helicopter pad
    • Transferring ICU patients >
      • Intra & Interhospital transfers
      • MRI transfers - special considerations
    • Organ & Tissue Donation
    • Welfare & other supports for patients and family >
      • Visiting times
      • Social work, pastoral care & aboriginal hospital liaison officer support
      • Interpreter services
      • Patient relations office
    • PROMPT
  • Professional development
    • Education & Training >
      • Learning and Training in ICU
      • ICU Education Curriculum
      • CICM Primary Exam education
    • Assessments, logbooks and mandatory training >
      • Procedures competency assessments / Logbook
      • Registrar Assessments and In-Training Evaluation Reports (ITERs)
      • Mandatory training for medical staff
    • Echocardiography in ICU
    • Crit-IQ
    • Other education opportunities
    • Mentorship
    • Looking after yourself and colleagues
    • BASIC Provider course
    • Paediatric BASIC provider course
    • Paediatric crit care education
    • Useful links and resources
  • Research/QI
    • Research >
      • STARRT AKI
      • SuDDICU
      • PLUS study
      • Recent Publications
    • Quality & Safety Audits >
      • Procedure database
      • NEAT Audit
      • ICU Discharge Audit
      • Documentation Audit
    • Administration for the ICU Procedural Database
  • Paediatric ICU
    • Introduction
    • PIPER Paediatric GO NOW Criteria
    • Criteria for admission of children to a regional hospital ICU or a paediatric ward HDU
    • Common Paediatric Conditions (SCV Guidelines) >
      • Asthma
      • Bronchiolitis >
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis
      • Seizures >
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child >
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
    • Paediatric Crit Care Education >
      • ED/Paeds education sessions
      • Other paediatric crit care education opportunities
    • Paediatric Resus Card
  • Emergency!
    • Code Blue: ALS algorithms >
      • Adult ALS algorithm
      • Paediatric ALS algorithm
      • Obstetric cardiac arrest flowchart
    • Emergency algorithms/mnemonics >
      • Airway
      • Breathing
      • Circulation >
        • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
      • Disability
    • MET calls: common scenarios >
      • Staff concern
      • The Dying Patient
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Oliguria/Anuria
    • MET calls: resources
    • Paediatric Resus Card