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Table 3 Proposed best practice interventions and daily process of care indicators

From: An innovative telemedicine knowledge translation program to improve quality of care in intensive care units: protocol for a cluster randomized pragmatic trial

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 ▪ administration of anticoagulant prophylaxis during first 48 hours
▪ use of antiembolic stockings if pharmacoprophylaxis contraindicated
- Number of eligible patients receiving appropriate anticoagulant prophylaxis
Ventilator weaning strategy ▪ 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 ▪ 7-point checklist for sterile insertion completed
▪ fulfilment of all 7 criteria listed on checklist
▪ 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 ▪ 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 ▪ Completion of the Braden index at least daily
▪ 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