Sharma & DEFAULT mnemonic Addressed by health D: Do not resuscitate (DNR) Increase in median days of * Peters comprising 7 professionals attending status is clear accidental tube removal (14 201318 ward round discussions in vs 150 days, P<0.0001) E: Endotracheal tube and cuff United intensive care. For is safe Trend towards an increase Kingdom mechanically ventilated in proportion of patients F: Fluid strategy and feeding paediatric patients who have tidal volumes in plan expected range (49% vs A: Agreed analgesia and 61%, P=0.09) sedation U: Ulcers of the skin and gastrointestinal tract L: Lines out T: Tidal volumes <8 ml/kg Sheth et al. I-PASS mnemonic: Handover process from I: Illness severity; stable, Time between verbal **** 201619 USA intensive care to acute needs watching, unstable and patient transfer I: Illness severity care unit decreased from baseline P: Patient summary; P: Patient summary (397 +/- 167 minutes) to the For paediatric patient summary statement, events A: Action list post-intervention period (24 transfers from the leading to admission, hospital +/- 21 minutes) (P < .01) S: Situation cardiovascular intensive course, ongoing assessment, awareness and care to acute care unit plan No differences in rates of contingency planning readmission, rapid A: Action list; to do list, time response team calls, or S: Synthesis by line and ownership; know mortality were observed receiver what is going on, plan for what might happen S: Situation awareness and contingency planning S: Synthesis by receiver; receiver summarises what
Sharma & Peters 201318 United Kingdom DEFAULT mnemonic comprising 7 Addressed by health professionals attending ward round discussions in intensive care. For mechanically ventilated paediatric patients D: Do not resuscitate (DNR) status is clear E: Endotracheal tube and cuff is safe F: Fluid strategy and feeding plan A: Agreed analgesia and sedation U: Ulcers of the skin and gastrointestinal tract L: Lines out T: Tidal volumes <8 ml/kg Increase in median days of accidental tube removal (14 vs 150 days, P<0.0001) Trend towards an increase in proportion of patients who have tidal volumes in expected range (49% vs 61%, P=0.09) * Sheth et al. 201619 USA I-PASS mnemonic: I: Illness severity P: Patient summary A: Action list S: Situation awareness and contingency planning S: Synthesis by receiver Handover process from intensive care to acute care unit For paediatric patient transfers from the cardiovascular intensive care to acute care unit I: Illness severity; stable, needs watching, unstable P: Patient summary; summary statement, events leading to admission, hospital course, ongoing assessment, plan A: Action list; to do list, time line and ownership; know what is going on, plan for what might happen S: Situation awareness and contingency planning S: Synthesis by receiver; receiver summarises what Time between verbal and patient transfer decreased from baseline (397 +/- 167 minutes) to the post-intervention period (24 +/- 21 minutes) (P < .01) No differences in rates of readmission, rapid response team calls, or mortality were observed ****
Rapid-review-Improving-documentation-at-transitions-of-care-for-complex-patients.docx