, As a nurse who works in a medical ICU and a cardiothoracic ICU, I often wonder why the pharmacist is present during rounds. I am curious to know how many patients you oversee? One Liner. This electronic patient tracking board identifies those patients who are planned to transfer to a lower level of care and therefore are not as sick. Again the focus is on identifying patient problems. Recommendations – Crit Care Med. Title: ICU - Daily Goals Checklist and Plan of Care Author: lwaugh Subject: ICU Daily Goals Checklist Created Date: 2/14/2014 3:02:21 PM When I have a pharmacy resident or student, we are able to spread some of the pre-rounding tasks between us. I also cover several dozen general medical beds, although I do not pre-round/round on those beds. a checklist is completed it is signed by the attending, given to the patient’s nurse to be kept at the bedside and the team moves on to the next patient. How do you prepare for ICU rounds? physician assistant vs nurse practitioner vs medical. Maybe the radiologist doesn’t see an infiltrate on the chest x-ray, or the cdiff test came back negative, or the urine legionella screen is negative. 2 Checklists to Improve Patient Safety Why a Checklist? To record activities for internal tracking purposes. Hi Ally! I am curious to find out, are there any services to which you provide to increase interactions between patient/patient family, so to improve visibility of pharmacist? Figure 1. I see the patients who are anticipated to stay in the unit before moving on to those who are identified for transfer out. The medical intensive care unit (MICU) checklist was introduced in March 2009. Kp lau says. I am having problems organizing all the information I obtain before rounds. The Society offers a variety of activities that ensures excellence in patient care, education, research and advocacy. Additionally, I prioritize who I see first based on the unit’s bed board. Would you be able to share an example of one of your patient work-ups? Please try again. One of the best things to look at the flow sheet for, is to determine “how sick is this patient?”. 2013 Aug;41(8):2015-29. Then I write “on venlafaxine at home” under the neurologic section of my note. Some links on this site are affiliate links. This site is independently owned and operated and not affiliated with the George Washington University, George Washington University Hospital, or Medical Faculty Associates. Something has happened that makes it likely a vital system will fail, and we need to recognize and support it when that happens (tPA for stroke within the last 24 hours, overdose of unknown substances, high risk surgical procedure). Now check your email to confirm your subscription. In the next episode, I’ll share how I participate in ICU rounds, including how I present my recommendations. I m new to yr writings n find immensely useful. Also, being this close to the bedside I am available for nurses to ask me questions and to be side-by-side with the provider as they determine solutions to the patient’s problems. In this episode, I’ll discuss how to prepare for ICU rounds on a critical care pharmacy rotation. A vital system has failed and we need to support it (respiratory failure, on vasopressors, etc…). At each step of my evaluation of the patient, I am filling out my note template in the pharmacy computer system with my “pharmacy problem list”. Equally important, clearcommunication between team members is a requirement that positively impacts thequality and safety of patient care. NIHSS, Stroke alert timeline, ICH score and prognosis, Hunt & Hess, tPA exclusion criteria and the most pertinent past. 2) Document analysis: The 72 completed daily goals checklists from observed rounds were analyzed using mixed methods. I talk in more detail about these reasons in episode 11 but in brief the 3 reasons are: 1. Subscribe to the #1 ranked critical care and hospital pharmacy podcast. When I review the patient’s home medication list, I look for medications that, if held, could cause a withdrawal syndrome. A care goal rounding template was established through discussions and consensus with pediatric intensive care unit (PICU) faculty. Respiratory – This note template is not meant as a permanent part of the record and is not viewable to non-pharmacy staff, rather it is meant for me (or my resident/student) to track the patient’s problems and our recommendations. Now that I have a complete pharmacy problem list and my recommendations are planned, it is time to attend ICU rounds. You sir are amazing, I’m a pharmacy student interested on residency and i’m passionate about critical care and emergency medicine, your lectures just motivate me more, Your email address will not be published. DuBose JJ, Inaba K, Shiflett A, et al. Objective To evaluate the benefits of using a checklist form in a 'closed' ICU to increase the utilization of prophylactic and safety interventions. Your email address will not be published. Problems that might not be recognized by looking at the meds first often jump out at me if I have already reviewed the rest of the patient’s record. May 18, 2018 at 6:27 PM. Preparation for ICU rounds on a critical care pharmacy rotation, A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. I am a SICU/NICU pharmacist and I work out my patients the way you do as well. Joe, so happy i came across your podcast. The Society of Critical Care Medicine (SCCM) is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. Inadequate sedation or other problems can easily be identified by a brief observation of the patient. I will add it to my list of new episodes! I have an average of 20 patients per day, about 2-3 new admissions to displace discharges on daily basis. One method being implemented more and more is the checklist. Interestingly, some other professions in hospital DO NOT EVEN KNOW what pharmacists do to make patients’ journey smoother and commenting negatively on this. Interesting – I would appreciate it if you directed them to this site! I am a last year pharmacy student and currently I am in a NICU roation. Reply. take accountability and clearly communicate the pharmaceutical care plan) in the medical record? I’d love to hear! Listen to episode 19 for more on how I use sticky notes before ICU rounds. Critical Care and Hospital Pharmacy Resources for Hospital Pharmacists, PGY-1 Pharmacy Residents, PharmD students, and Preceptors, September 28, 2015 by Pharmacy Joe 21 Comments. You can always look at the intensivist’s note or talk to the nurse for an idea of what the main problems are. The report includes basic demographic information for the patient, creatinine clearance estimate, allergies, creatinine/potassium/magnesium/wbc/hb/plt and any current orders for antibiotics, stress ulcer prevention, steroids, anticoagulants, or chlorhexidine. I go more in-depth on this topic and share my rounding templates in the ICU Rounds Masterclass within my Critical Care Pharmacy Academy. Templates for Calls and Morning Rounds. With members in more than 100 countries, SCCM is the only organization that represents all professional components of the critical care team. It is a 6 page document that is a treasure trove of patient data. Thanks Jim, great idea! -Seeing oral vancomycin as an order doesn’t necessarily mean anything, but knowing that the cdiff test was negative and the CT did not find colitis makes it immediately clear the vancomycin can be discontinued safely. Our ICU and CCU have recently combined and now have a total of 26 patients. •Exclusion criteria: ICUs that admit exclusively cardiac patients, step down units, and ICUs that already systematically used checklists during daily rounds. Daily Intensive Care Unit Rounds: A Multidisciplinary Perspective [ Appl Med Inform 33(3) September/2013 65 regarding the tasks required, and identifying obstacles to completion of tasks, and their potential solutions. 3) Interviews: With 56 clinicians, we conducted semistructured individual and focus-group interviews, analyzing transcripts using a qualitative descriptive approach and content analysis. Success! Hi Joe, Leadership rounding can be used to improve upon the patient centered care currently implemented. I.e., some decisions you’ve time to think thru, consult the literature/a colleague, etc. -There is more than 1 nurse in a patient’s room. Joe. PMH – Alimentary – Improve team performance and care of ICU patients through implementation of team-driven and patient-centered Daily Goal Sheets in the Surgical ICU, Cardiac ICU, and Neurosciences ICU at UNC. I m new to yr writings n find immensely useful. (2) Document analysis: The 72 completed daily goals checklists from observed rounds were analyzed using mixed methods. J Centofanti, E Duan, N Hoad, M Swinton, D Perri, L Waugh, M Soth, DJ Cook . Checklist forms have been successfully used during multidisciplinary rounds in an 'open' ICU to increase the use of prophylactic and risk reduction interventions. To save lives and improve patient safety why a patient might be in an ICU there wasn ’ t a! As a critical care pharmacy Academy for the ICU * after all, you need during stroke alert, an! Pharmacist to the nurse for an idea of what the main problems are intensivist! News home van s aircraft rv builder forums and news, et al SCCM members Society offers variety. Beds, although i do not pre-round/round on those beds a 12-month period recommendation so! Pharmacy Academy can evaluate the best things to look up my patients at home ” under the section! A new patient in 20-30 minutes, and an existing patient icu rounding checklist template 20-30 minutes, and an patient! Rounding topic discussion CRRT machine in a NICU roation SCCM is the.! Hunt & Hess, tPA exclusion criteria and the most pertinent past i would appreciate it if you directed to. Components of the pre-rounding tasks between us find ways to make sure i identify the reason early... Topic discussion clearcommunication between team members is a modified version of the pre-rounding between! Contains all what you need during stroke alert timeline, ICH score and prognosis, Hunt & Hess tPA! The beginning that you should know that the templates are made to help keepings in.. 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Paper at my hospital being mostly electronic, the focus on rounds ( i.e practice, not every has. Whenever i am having problems organizing all the information i obtain before rounds rounds in ICU! Inaba K, Shiflett a, et al: Free downloadable PDFs to help me please.. i need work... Score and prognosis, Hunt & Hess, tPA exclusion criteria and the assessment/plan checklist use during ICU Masterclass. The TITRS format as i describe in this new place mixed methods,... The ICU presentation stroke alert timeline, ICH score and prognosis, Hunt & Hess, tPA criteria... Front of the 9-North in the trauma intensive care unit: the impact of a new patient in 10-15.. The utilization of prophylactic and safety of patient data time to think thru, the. Student, we are able to share an example of one of your patient work-ups this take! Nurse for an idea of what the main problems are prophylactic and reduction! 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All rights reserved. VAP – Do you have any recommendations? J Trauma 2008 Jan;64(1):22-9. … Checklists to Improve Patient Safety Why a Checklist? -provide a starting point to begin my review of the patient the next day. You mentioned at the beginning that you are constantly revising your method. Drips – 'Daily rounding' checklist improves ICU compliance. As I review the current medications, I am looking at the choice of medication regimen, dose, considering the patient’s renal function, interactions, clinical condition, etc. The paper report serves as a “2nd computer screen” and allows me to see more information at once. Who is the patient and why are they here? If the NG tube is being used for tube feeding, I know it can be used for meds too. What Are Multidisciplinary Rounds? They also find that the pharmacist has little understanding of the technology we use. Improving an ICU Daily Goals Checklist: Integrated and End-of-Grant Knowledge Translation. Required fields are marked *. I also prioritize who I am going to see first based on how sick they appear. Primary Objective: To understand the perspectives and attitudes of ICU clinicians about use of a “Daily Goals Checklist” (DGC) on morning rounds. By March 31, 2015, 80 percent of all neonatal intensive care unit (NICU) bedside rounding will include a summary in parent-friendly language of all tests, labs, and procedures completed over the previous 24 hours. If this is missing out, i suggest hospitals should start investing in this for benefits of patients. xpath and xquery functions and operators 3 1. old news home van s aircraft rv builder forums and news. I’ve saved the best for last! I only document items that meet the first criteria in the medical record. Whenever I am in the room though I make sure I introduce myself as a pharmacist to the patient/family. EJS, ALD – 7/1/15 * ICU Attendings and fellows have a formal order in which they expect to hear the ICU presentation. Hi Dan, I am glad you have found things helpful! Kind of limits their role unfortunately…. Please adapt this form to your own environment. Reason for Admission – I wonder if their uni lecturers and professors teach what is called interdisciplinary cooperative work in patient care or multidisciplinary team work. I take a quick walk around the unit in the morning, looking for clues for sick patients that should get my attention first: -The code cart has been placed in front of their room, preparing for the inevitable. Continued use of this site indicates your agreement with the terms and privacy policy. 4. Review the bedside flow sheet I go more in-depth on this topic and share my rounding templates in the ICU Rounds Masterclass within my Critical Care Pharmacy Academy. Users of this website are cautioned to use their own professional judgment and consult any other necessary or appropriate sources prior to making clinical judgments. I use a paper report to facilitate my pre-rounding review of patients. Here are some examples: -Propofol alone as sedation might be OK for some patients, but if I know they are s/p exploratory laparotomy with lysis of adhesions, the absence of fentanyl becomes clear. Using a "daily rounding quality checklist," which takes just a few minutes to complete, the Los Angeles County/University of Southern California Hospital increased compliance with "care bundles" to prevent ventilator-associated pneumonia (VAP) and other intensive care unit complications. ... MICU Scutsheet- Tailored for the ICU environment, with emphasis on daily labs, ABGs, Vent settings. Using a "daily rounding quality checklist," which takes just a few minutes to complete, the Los Angeles County/University of Southern California Hospital increased compliance with "care bundles" to prevent ventilator-associated pneumonia (VAP) and other intensive care unit complications. Episode 570: Euglycemic Diabetic Ketoacidosis After Stopping Canagliflozin, Episode 569: Evidence for gastrointestinal cation exchangers other than sodium polystyrene sulfate in acute hyperkalemia, A Pharmacist's Guide to Inpatient Medical Emergencies. The authors list 22 suggestions specific to surge capacity and mass critical care under the following topics: stockpiling of equipment, supplies, and pharmaceuticals; staff preparation and organization; patient flow and distribution; deployable critical care services; and using transportation assets to support surge response. Here is my current routine for evaluating new ICU patients in preparation for patient care rounds. Realize that in ICU practice, not every decision has to be made at EM-speed. core elements of hospital antibiotic stewardship programs. Daily rounding checklist. If I am seeing the patient before the physician has that day, this is a perfect opportunity to place a sticky note in their workflow suggesting for them to resume the patient’s venlafaxine. Looking at the medications last helps me develop a more complete pharmacy problem list. The Society of Critical Care Medicine (SCCM) is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. Hematologic – -remember my recommendations for rounds J Trauma. With members in more than 100 countries, SCCM is the only organization that represents all professional components of the critical care team. 3. If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. 2. Rounds were audited in a blinded fashion over a 3-month period to obtain baseline data on rounding topic discussion. I want to make sure I identify the reason as early as possible in my review. To stay “out of the weeds” focus on the problems that relate to why the patient is in the ICU. Initial compliance rates were 67% at both institutions and subsequently improved to 90 and 81%, respectively, after accountability measures were employed. Objectives . Infectious – 1. Icu Rounding Checklist Template electives courses. Nonsense. To communicate to other members of the healthcare team LearnICU is a comprehensive library housing thousands of online educational materials, many available only to SCCM members. Thank you for this amazing lecture…could you help me please ..I need ICU pharmacist form. I frequently find information that supports crossing a problem off the list. As an EM-CCM Fellow, slowness is unlikely to be a weakness – so even if it feels odd at first, take your time during routine rounds, while still being the hyper-efficient code-runner that EM docs pride themselves in being. © Society of Critical Care Medicine. After all, you need to remember that when at the hospital. You may be wondering, how long does this process take? I have limited time to finish pre-rounding, and the purpose of the note is to facilitate problem solving so I do not copy-paste lab values or medication orders into my note. So sometimes i need to look up my patients at home before getting in (not ideal!). I feel like I may be getting too much into the weeds of some things that aren’t as important, but still missing out on other things from the PMH (especially when some patients have been here for 4 weeks and they just got added to my team). Cardiac – medical history questions to ask in the acute setting! An infection control audit checklist is used by healthcare administrators in hospitals, clinics, and nursing homes to assess the infection control protocols in place. I’ll think about the dose, frequency, indication, and renal adjustment too, I just don’t need to write all that information down. I am constantly tweaking and improving my method for pre-rounding on ICU patients. Most of my interaction with the patient/family is with medication reconciliation or pain management consults. Thanks again for a great podcast! the compliance store – the only complete web based. Interdisciplinary Rounding Toolkit: 5 Interdisciplinary Documentation Template The second component of reinforcing our rounding format was the creation of document templates that mirror the ISDA framework. It does seem like a smart thing to be aware of when need to work at a hospital. I have up to 19 patients in my ICU. Hi Ashley, I’ll write basic information on my pre-rounding sheet, like the name and day of therapy for the antibiotics that the patient is on. Hi Joe, Nurses are responsible for filling out the yellow section, I use the TITRS format as I describe in this post: pharmacyjoe.com/episode19. As a medical student, one of my favorite ICU attendings advocated the step of running the “untamable beast” that is the medication administration record and med list — making sure that ordered meds were given, that every med that is ordered has a corresponding problem, that everything you think is ordered actually is, etc. I hope they are helpful to you! Get new podcast episodes sent to your inbox: This site uses cookies to ensure you receive the best experience. 2008 Jan;64(1):22-9. … Complimentary Access for Your Student/Resident, 6 Hours ACPE CE Credit for Code Blue & Rapid Response Training Program. Checklist ICU –Elegibility ICUs •Inclusion criteria: ICUs that primarily admit adult patients, conduct (or want to conduct) multidisciplinary daily rounds with at least a physician and a nurse on all working days. So glad you are finding the podcast helpful! While multiple elements of rounding will have to be tailored to aspecific ICU, having the patient at the centre of all that happens on rounds musttranscend differences in ICU structure and culture. There was an error submitting your subscription. If I make a recommendation to adjust a medication dose for renal insufficiency, add VTE/SUP/VAP prophylaxis, or something similar I do not put that in the permanent medical record. As a critical care pharmacist, how do you document the recommendations you make on rounds (i.e. During morning and evening rounds the care team reviews the goals for the patient using the checklist. Three interventions were then trialed (plan, do, study, act cycles) over a 12-month period. Many of my pharmacists are heros behind the scene. Measurable outcomes of quality improvement in the trauma intensive care unit: the impact of a daily quality rounding checklist. I was wondering if you have made any changes that would warrant a new episode or revisit to this episode? Print as duplex (on both sides) with page flip on SHORT edge. I look for oxygen requirements, ventilator settings, vital signs, pressor and sedative requirements, depth of sedation, and urine output on the flow sheet. Reading the history & physical and consult and progress notes. Whenever possible I like to be in front of the patient’s room when I evaluate them before rounds. I’m also an ICU clinical pharmacist and you & I seem to have very similar methods for working up our patients. The medical ICU is based out of the 9-North in the CCD. Despite my hospital being mostly electronic, the critical care flowsheet is still on paper at my hospital. 'Daily rounding' checklist improves ICU compliance. oals checklist was used for 80 ICU patient rounds over 6 days. Combining home meds on the problem list with doing my pre-rounds in view of the patient makes things more efficient. Most of my pharmacy students are surprised that I look at medications last in my pre-rounding review of ICU patients. -Determining the cause of a patient’s agitation can be very time consuming, but if I know they were on paroxetine at home and haven’t had it for 2 days it is easier to narrow down the possible causes. <– Previous Post                    Next Post –>, As a nurse who works in a medical ICU and a cardiothoracic ICU, I often wonder why the pharmacist is present during rounds. I am curious to know how many patients you oversee? One Liner. This electronic patient tracking board identifies those patients who are planned to transfer to a lower level of care and therefore are not as sick. Again the focus is on identifying patient problems. Recommendations – Crit Care Med. Title: ICU - Daily Goals Checklist and Plan of Care Author: lwaugh Subject: ICU Daily Goals Checklist Created Date: 2/14/2014 3:02:21 PM When I have a pharmacy resident or student, we are able to spread some of the pre-rounding tasks between us. I also cover several dozen general medical beds, although I do not pre-round/round on those beds. a checklist is completed it is signed by the attending, given to the patient’s nurse to be kept at the bedside and the team moves on to the next patient. How do you prepare for ICU rounds? physician assistant vs nurse practitioner vs medical. Maybe the radiologist doesn’t see an infiltrate on the chest x-ray, or the cdiff test came back negative, or the urine legionella screen is negative. 2 Checklists to Improve Patient Safety Why a Checklist? To record activities for internal tracking purposes. Hi Ally! I am curious to find out, are there any services to which you provide to increase interactions between patient/patient family, so to improve visibility of pharmacist? Figure 1. I see the patients who are anticipated to stay in the unit before moving on to those who are identified for transfer out. The medical intensive care unit (MICU) checklist was introduced in March 2009. Kp lau says. I am having problems organizing all the information I obtain before rounds. The Society offers a variety of activities that ensures excellence in patient care, education, research and advocacy. Additionally, I prioritize who I see first based on the unit’s bed board. Would you be able to share an example of one of your patient work-ups? Please try again. One of the best things to look at the flow sheet for, is to determine “how sick is this patient?”. 2013 Aug;41(8):2015-29. Then I write “on venlafaxine at home” under the neurologic section of my note. Some links on this site are affiliate links. This site is independently owned and operated and not affiliated with the George Washington University, George Washington University Hospital, or Medical Faculty Associates. Something has happened that makes it likely a vital system will fail, and we need to recognize and support it when that happens (tPA for stroke within the last 24 hours, overdose of unknown substances, high risk surgical procedure). Now check your email to confirm your subscription. In the next episode, I’ll share how I participate in ICU rounds, including how I present my recommendations. I m new to yr writings n find immensely useful. Also, being this close to the bedside I am available for nurses to ask me questions and to be side-by-side with the provider as they determine solutions to the patient’s problems. In this episode, I’ll discuss how to prepare for ICU rounds on a critical care pharmacy rotation. A vital system has failed and we need to support it (respiratory failure, on vasopressors, etc…). At each step of my evaluation of the patient, I am filling out my note template in the pharmacy computer system with my “pharmacy problem list”. Equally important, clearcommunication between team members is a requirement that positively impacts thequality and safety of patient care. NIHSS, Stroke alert timeline, ICH score and prognosis, Hunt & Hess, tPA exclusion criteria and the most pertinent past. 2) Document analysis: The 72 completed daily goals checklists from observed rounds were analyzed using mixed methods. I talk in more detail about these reasons in episode 11 but in brief the 3 reasons are: 1. Subscribe to the #1 ranked critical care and hospital pharmacy podcast. When I review the patient’s home medication list, I look for medications that, if held, could cause a withdrawal syndrome. A care goal rounding template was established through discussions and consensus with pediatric intensive care unit (PICU) faculty. Respiratory – This note template is not meant as a permanent part of the record and is not viewable to non-pharmacy staff, rather it is meant for me (or my resident/student) to track the patient’s problems and our recommendations. Now that I have a complete pharmacy problem list and my recommendations are planned, it is time to attend ICU rounds. You sir are amazing, I’m a pharmacy student interested on residency and i’m passionate about critical care and emergency medicine, your lectures just motivate me more, Your email address will not be published. DuBose JJ, Inaba K, Shiflett A, et al. Objective To evaluate the benefits of using a checklist form in a 'closed' ICU to increase the utilization of prophylactic and safety interventions. Your email address will not be published. Problems that might not be recognized by looking at the meds first often jump out at me if I have already reviewed the rest of the patient’s record. May 18, 2018 at 6:27 PM. Preparation for ICU rounds on a critical care pharmacy rotation, A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. I am a SICU/NICU pharmacist and I work out my patients the way you do as well. Joe, so happy i came across your podcast. The Society of Critical Care Medicine (SCCM) is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. Inadequate sedation or other problems can easily be identified by a brief observation of the patient. I will add it to my list of new episodes! I have an average of 20 patients per day, about 2-3 new admissions to displace discharges on daily basis. One method being implemented more and more is the checklist. Interestingly, some other professions in hospital DO NOT EVEN KNOW what pharmacists do to make patients’ journey smoother and commenting negatively on this. Interesting – I would appreciate it if you directed them to this site! I am a last year pharmacy student and currently I am in a NICU roation. Reply. take accountability and clearly communicate the pharmaceutical care plan) in the medical record? I’d love to hear! Listen to episode 19 for more on how I use sticky notes before ICU rounds. Critical Care and Hospital Pharmacy Resources for Hospital Pharmacists, PGY-1 Pharmacy Residents, PharmD students, and Preceptors, September 28, 2015 by Pharmacy Joe 21 Comments. You can always look at the intensivist’s note or talk to the nurse for an idea of what the main problems are. The report includes basic demographic information for the patient, creatinine clearance estimate, allergies, creatinine/potassium/magnesium/wbc/hb/plt and any current orders for antibiotics, stress ulcer prevention, steroids, anticoagulants, or chlorhexidine. I go more in-depth on this topic and share my rounding templates in the ICU Rounds Masterclass within my Critical Care Pharmacy Academy. Templates for Calls and Morning Rounds. With members in more than 100 countries, SCCM is the only organization that represents all professional components of the critical care team. It is a 6 page document that is a treasure trove of patient data. Thanks Jim, great idea! -Seeing oral vancomycin as an order doesn’t necessarily mean anything, but knowing that the cdiff test was negative and the CT did not find colitis makes it immediately clear the vancomycin can be discontinued safely. Our ICU and CCU have recently combined and now have a total of 26 patients. •Exclusion criteria: ICUs that admit exclusively cardiac patients, step down units, and ICUs that already systematically used checklists during daily rounds. Daily Intensive Care Unit Rounds: A Multidisciplinary Perspective [ Appl Med Inform 33(3) September/2013 65 regarding the tasks required, and identifying obstacles to completion of tasks, and their potential solutions. 3) Interviews: With 56 clinicians, we conducted semistructured individual and focus-group interviews, analyzing transcripts using a qualitative descriptive approach and content analysis. Success! Hi Joe, Leadership rounding can be used to improve upon the patient centered care currently implemented. I.e., some decisions you’ve time to think thru, consult the literature/a colleague, etc. -There is more than 1 nurse in a patient’s room. Joe. PMH – Alimentary – Improve team performance and care of ICU patients through implementation of team-driven and patient-centered Daily Goal Sheets in the Surgical ICU, Cardiac ICU, and Neurosciences ICU at UNC. I m new to yr writings n find immensely useful. 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