ICU transfer checklist improves patient safety

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A standardized checklist for transferring neuroscience intensive care unit (ICU) patients to hospital services can help improve medication reconciliation and decrease patient time with a urinary catheter, according to a study abstract presented at the annual meeting of the American Neurological Association.

Use of the digitized checklist led to a 20 percent increase in medication reconciliation and a 22 percent decrease in urinary catheterization time, according to lead researcher Elizabeth A. Coon, M.D., of the Mayo Clinic and her team.

The checklist, which asked questions about prophylaxis, medication reconciliation and urinary catheter placement, was uploaded into neuroscience ICU patient charts as an automatic prompt. The researchers analyzed 130 transfers before and 131 after its implementation from October 2011 to January 2012, looking at length of stay, time of transfer order, duration and status of urinary catheter, adverse events, ICU readmission, and medication reconciliation of IV anti-hypertensives or vasopressors, according to the study. After implementing the template, staff used it 93 percent of the time.

The Mayo Clinic plans to implement the checklist into its standard transfer process, making it mandatory for any patient being transferred from the neuroscience ICU, Coon told MedPageToday.

Coon also said hospitals could apply the template to other ICUs. "I think this could be used in any ICU, not just a neuro-specific ICU, because often patients come out of ICU with unnecessary catheter use, and that predisposes to longer catheterization and urinary tract infections, as well as unnecessary medications that are not to be used on the floor," she told MedPage Today.

The transfer process both in and out of ICUs is vitally important. A May study found delaying transfers to the ICU increases patient mortality risk, with a patient's odds of dying increasing 7 percent with every hour the transfer was stalled, FierceHealthcare previously reported.  

To learn more:
- here's the study abstract (.pdf)
- read the MedPage Today article

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