Table 3 Proposed best practice interventions and daily process of care indicators
Best practice | Process of care indicator | Unit of measurement |
|---|---|---|
Prevention of ventilator-associated pneumonia | ▪ head of bed elevation(≥ 30°) ▪ route of intubation | - Number of eligible patient-days with head elevation ≥ 30° - Number of eligible patient days associated with endotracheal intubation |
Prophylaxis against venous thromboembolism | â–ª administration of anticoagulant prophylaxis during first 48 hours â–ª use of antiembolic stockings if pharmacoprophylaxis contraindicated | - Number of eligible patients receiving appropriate anticoagulant prophylaxis |
Ventilator weaning strategy | â–ª spontaneous breathing trial or extubation within previous 24 hours | - Number of eligible patient-days on which spontaneous breathing trial (or extubation) was performed |
Prevention of catheter-related bloodstream infections | â–ª 7-point checklist for sterile insertion completed â–ª fulfilment of all 7 criteria listed on checklist â–ª anatomic site of catheter insertion | - Number of central venous catheters inserted using all 7 criteria on checklist - Number of central venous catheters inserted at the subclavian site |
Early enteral feeding | â–ª Initiation of enteral feeds within 48 hours of ICU admission | - Number of eligible patients receiving early enteral feeding within 48 hours of ICU admission - Number of eligible patients achieving 50% of their target caloric goal via the enteral route by 72 hours |
Pressure ulcer prevention | â–ª Completion of the Braden index at least daily â–ª Use of specialized mattress or bedding material to relieve pressure | - Number of patient days with Braden index completed - Number of patients receiving specialized mattress or bedding/all eligible patients |