BH ICU Manual
  • Home
  • Administration
    • Team members
    • Useful contacts
    • Orientation & Guides
    • Roster rules for ICU junior doctors (Appendix A)
    • App user tips
      • FindMyShift
      • Kronos
      • Synapse
      • Offsite access to additional email addresses
    • VHIMS
      • VHIMS Resources (intranet only)
      • How to enter a VHIMS (intranet only)
    • Social Media Etiquette
    • BASIC equipment loan
    • Medical Students in ICU
    • ICU Consultants Only
      • Echuca Telehealth Consults
      • Shift swap form for consultants
      • CME Claim Process
    • ERH VITCCU
  • Clinical
    • Interface with ED & home teams
      • ED
      • Surgical teams
      • Cardiology
      • Paediatrics
    • Admissions & Discharges
      • Admissions & Discharges
      • Admission guidelines for surgical elective and emergency operations
    • Admission guidelines for surgical elective and emergency operations
    • 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
    • Care bundle
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Care of the Post-Operative Patient
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols + Guidelines
      • RAPID COVID, INFLUENZA AND RSV TESTING
      • Approach to patient with suspected influenza
      • Stroke Protocol (SCV Oct 2018)
    • NIV
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
    • CRRT
    • Procedures
    • Patient transfers
      • Emergency calls to the helicopter pad
      • Transferring ICU patients
        • Intra & Interhospital transfers
        • MRI transfers - special considerations
    • Welfare & other supports for patients and family
      • Social work, pastoral care & aboriginal hospital liaison officer support
      • Interpreter services
      • Patient relations office
  • Beyond Clinical
    • Education & Training
      • Education & Training
        • Learning and Training in ICU
        • Bendigo Health ICU Medical Education Principles
          • Departmental overview
          • Medical Stream
          • Medical Weekly Schedule
            • Wednesdays
            • Airway training (hands-on-real time) in Operating theatre
            • Radiology Conference
            • ‘Labs/lytes’ session or equipment or Journal club
            • Tracheostomy day for doctors
            • Deteriorating patient workshop
            • Ambu Bronchoscope and Cook Surgical Airway CPD workshop
            • Crucial Conversation workshop
            • Team Skills simulation day
            • ALS Simulation
            • Level 1 ECHO training
            • External Speakers
            • VICEN
            • Bendigo ICU Journal club
          • Expectations for Consultants
          • Expectations for all ICU Registrars
          • Expectations for HMOs
          • Medical Student program
          • North West Training Hub
          • ICU Simulation
        • Curated educational videos & websites
          • Virtual bronchoscopy
        • Mandatory training for medical staff
      • Term Assessments
        • Registrar Assessments and In-Training Evaluation Reports (ITERs)
        • Registrar term assessments (consultant access only)
          • Term Assessment form (consultant access only)
      • BASIC Provider & Instructor Courses
      • Paediatric BASIC Provider & Instructor Courses
      • Other education opportunities
      • Paediatric crit care education
      • Useful learning links
    • Research & Quality
      • Research
        • Recent Publications
    • Well-being
      • Mentorship
      • Looking after yourself and colleagues
    • Medical Students in ICU
  • Paediatric ICU
    • Introduction
    • GO NOW Criteria
    • Admission criteria for paediatric HDU/ICU
    • Commonly used SCV Paediatric Guidelines
      • Asthma
      • Bronchiolitis
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis
        • Algorithm for the management of DKA (to be read in conjunction with SCV guideline)
        • SCV - Diabetic ketoacidosis
      • Seizures
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
      • Dehydration
        • Dehydration
        • IV fluid management
    • Paediatric Resus Card
  • Emergency!
    • Code Blue: ALS algorithms
      • Adult ALS algorithm
      • Paediatric ALS algorithm
      • Obstetric cardiac arrest flowchart
    • Emergency algorithms/mnemonics
      • Airway
      • Breathing
      • Circulation
      • Disability
    • MET calls: common scenarios
      • Staff concern
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Interface with other disciplines
      • Oliguria/Anuria
    • MET calls: resources
    • Paediatric Resus Card
  • Home
  • Administration
    • Team members
    • Useful contacts
    • Orientation & Guides
    • Roster rules for ICU junior doctors (Appendix A)
    • App user tips
      • FindMyShift
      • Kronos
      • Synapse
      • Offsite access to additional email addresses
    • VHIMS
      • VHIMS Resources (intranet only)
      • How to enter a VHIMS (intranet only)
    • Social Media Etiquette
    • BASIC equipment loan
    • Medical Students in ICU
    • ICU Consultants Only
      • Echuca Telehealth Consults
      • Shift swap form for consultants
      • CME Claim Process
    • ERH VITCCU
  • Clinical
    • Interface with ED & home teams
      • ED
      • Surgical teams
      • Cardiology
      • Paediatrics
    • Admissions & Discharges
      • Admissions & Discharges
      • Admission guidelines for surgical elective and emergency operations
    • Admission guidelines for surgical elective and emergency operations
    • 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
    • Care bundle
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Care of the Post-Operative Patient
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols + Guidelines
      • RAPID COVID, INFLUENZA AND RSV TESTING
      • Approach to patient with suspected influenza
      • Stroke Protocol (SCV Oct 2018)
    • NIV
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
    • CRRT
    • Procedures
    • Patient transfers
      • Emergency calls to the helicopter pad
      • Transferring ICU patients
        • Intra & Interhospital transfers
        • MRI transfers - special considerations
    • Welfare & other supports for patients and family
      • Social work, pastoral care & aboriginal hospital liaison officer support
      • Interpreter services
      • Patient relations office
  • Beyond Clinical
    • Education & Training
      • Education & Training
        • Learning and Training in ICU
        • Bendigo Health ICU Medical Education Principles
          • Departmental overview
          • Medical Stream
          • Medical Weekly Schedule
            • Wednesdays
            • Airway training (hands-on-real time) in Operating theatre
            • Radiology Conference
            • ‘Labs/lytes’ session or equipment or Journal club
            • Tracheostomy day for doctors
            • Deteriorating patient workshop
            • Ambu Bronchoscope and Cook Surgical Airway CPD workshop
            • Crucial Conversation workshop
            • Team Skills simulation day
            • ALS Simulation
            • Level 1 ECHO training
            • External Speakers
            • VICEN
            • Bendigo ICU Journal club
          • Expectations for Consultants
          • Expectations for all ICU Registrars
          • Expectations for HMOs
          • Medical Student program
          • North West Training Hub
          • ICU Simulation
        • Curated educational videos & websites
          • Virtual bronchoscopy
        • Mandatory training for medical staff
      • Term Assessments
        • Registrar Assessments and In-Training Evaluation Reports (ITERs)
        • Registrar term assessments (consultant access only)
          • Term Assessment form (consultant access only)
      • BASIC Provider & Instructor Courses
      • Paediatric BASIC Provider & Instructor Courses
      • Other education opportunities
      • Paediatric crit care education
      • Useful learning links
    • Research & Quality
      • Research
        • Recent Publications
    • Well-being
      • Mentorship
      • Looking after yourself and colleagues
    • Medical Students in ICU
  • Paediatric ICU
    • Introduction
    • GO NOW Criteria
    • Admission criteria for paediatric HDU/ICU
    • Commonly used SCV Paediatric Guidelines
      • Asthma
      • Bronchiolitis
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis
        • Algorithm for the management of DKA (to be read in conjunction with SCV guideline)
        • SCV - Diabetic ketoacidosis
      • Seizures
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
      • Dehydration
        • Dehydration
        • IV fluid management
    • Paediatric Resus Card
  • Emergency!
    • Code Blue: ALS algorithms
      • Adult ALS algorithm
      • Paediatric ALS algorithm
      • Obstetric cardiac arrest flowchart
    • Emergency algorithms/mnemonics
      • Airway
      • Breathing
      • Circulation
      • Disability
    • MET calls: common scenarios
      • Staff concern
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Interface with other disciplines
      • 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
    • Useful contacts
    • Orientation & Guides
    • Roster rules for ICU junior doctors (Appendix A)
    • App user tips
      • FindMyShift
      • Kronos
      • Synapse
      • Offsite access to additional email addresses
    • VHIMS
      • VHIMS Resources (intranet only)
      • How to enter a VHIMS (intranet only)
    • Social Media Etiquette
    • BASIC equipment loan
    • Medical Students in ICU
    • ICU Consultants Only
      • Echuca Telehealth Consults
      • Shift swap form for consultants
      • CME Claim Process
    • ERH VITCCU
  • Clinical
    • Interface with ED & home teams
      • ED
      • Surgical teams
      • Cardiology
      • Paediatrics
    • Admissions & Discharges
      • Admissions & Discharges
      • Admission guidelines for surgical elective and emergency operations
    • Admission guidelines for surgical elective and emergency operations
    • 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
    • Care bundle
      • Post-cardiac arrest care (TTM) (PROMPT)
      • Care of the Post-Operative Patient
      • Spinal Trauma- CPG's (includes cervical spine clearance) (PROMPT)
      • Management Of Uncontrolled, Life Threatening Bleeding (Massive Exsanguination) (PROMPT)
    • Clinical Protocols + Guidelines
      • RAPID COVID, INFLUENZA AND RSV TESTING
      • Approach to patient with suspected influenza
      • Stroke Protocol (SCV Oct 2018)
    • NIV
      • Domiciliary (Home) non-invasive ventilation (NIV)/CPAP patients
      • NIV (PROMPT)
    • Tracheostomy Management
    • PICCO decision making tree
    • CRRT
    • Procedures
    • Patient transfers
      • Emergency calls to the helicopter pad
      • Transferring ICU patients
        • Intra & Interhospital transfers
        • MRI transfers - special considerations
    • Welfare & other supports for patients and family
      • Social work, pastoral care & aboriginal hospital liaison officer support
      • Interpreter services
      • Patient relations office
  • Beyond Clinical
    • Education & Training
      • Education & Training
        • Learning and Training in ICU
        • Bendigo Health ICU Medical Education Principles
          • Departmental overview
          • Medical Stream
          • Medical Weekly Schedule
            • Wednesdays
            • Airway training (hands-on-real time) in Operating theatre
            • Radiology Conference
            • ‘Labs/lytes’ session or equipment or Journal club
            • Tracheostomy day for doctors
            • Deteriorating patient workshop
            • Ambu Bronchoscope and Cook Surgical Airway CPD workshop
            • Crucial Conversation workshop
            • Team Skills simulation day
            • ALS Simulation
            • Level 1 ECHO training
            • External Speakers
            • VICEN
            • Bendigo ICU Journal club
          • Expectations for Consultants
          • Expectations for all ICU Registrars
          • Expectations for HMOs
          • Medical Student program
          • North West Training Hub
          • ICU Simulation
        • Curated educational videos & websites
          • Virtual bronchoscopy
        • Mandatory training for medical staff
      • Term Assessments
        • Registrar Assessments and In-Training Evaluation Reports (ITERs)
        • Registrar term assessments (consultant access only)
          • Term Assessment form (consultant access only)
      • BASIC Provider & Instructor Courses
      • Paediatric BASIC Provider & Instructor Courses
      • Other education opportunities
      • Paediatric crit care education
      • Useful learning links
    • Research & Quality
      • Research
        • Recent Publications
    • Well-being
      • Mentorship
      • Looking after yourself and colleagues
    • Medical Students in ICU
  • Paediatric ICU
    • Introduction
    • GO NOW Criteria
    • Admission criteria for paediatric HDU/ICU
    • Commonly used SCV Paediatric Guidelines
      • Asthma
      • Bronchiolitis
        • Bronchiolitis
        • Respiratory Distress Score for monitoring patients with bronchiolitis on HFNC and CPAP
      • Croup
      • Diabetic ketoacidosis
        • Algorithm for the management of DKA (to be read in conjunction with SCV guideline)
        • SCV - Diabetic ketoacidosis
      • Seizures
        • Febrile seizures
        • Non-febrile seizures
      • The Septic Child
        • Assessment & Management (SCV)
        • Criteria for rapid ICU admission of children with sepsis
      • Dehydration
        • Dehydration
        • IV fluid management
    • Paediatric Resus Card
  • Emergency!
    • Code Blue: ALS algorithms
      • Adult ALS algorithm
      • Paediatric ALS algorithm
      • Obstetric cardiac arrest flowchart
    • Emergency algorithms/mnemonics
      • Airway
      • Breathing
      • Circulation
      • Disability
    • MET calls: common scenarios
      • Staff concern
      • Hypoxic Type 1 Respiratory Failure
      • Hypercapnoeic Type 2 Respiratory Failure
      • Atrial Fibrillation
      • Hypotension and CV Shock
      • Altered consciousness
      • The Agitated Patient
      • Interface with other disciplines
      • Oliguria/Anuria
    • MET calls: resources
    • Paediatric Resus Card