Structure and concept of ICU rounds: the VIS-ITS survey

Abstract

Objective To gather data about structural and procedural characteristics of patient rounds in the intensive care unit (ICU) setting. Design A structured online survey was offered to members of two German intensive care medicine societies. Measurements and main results Intensivists representing 390 German ICUs participated in this study (university hospitals 25%, tertiary hospitals 23%, secondary hospitals 36%, primary hospitals 16%). In 90% of participating ICUs, rounds were reported to take place in the morning and cover an average of 12 intensive care beds and 6 intermediate care beds within 60 min. With an estimated bed occupancy of 80%, this averaged to 4.3 min spent per patient during rounds. In 96% of ICUs, rounds were stated to include a bedside visit. On weekdays, 86% of the respondents reported holding a second ICU round with the attendance of a qualified decision-maker (e.g. board-certified intensivist). On weekends, 79% of the ICUs performed at least one round with a decision-maker per day. In 18%, only one ICU round per weekend was reported, mostly on Sundays. The highest-qualified decision-maker present during rounds on most ICUs was an ICU attending (57%). Residents (96%) and intensive care nurses (87%) were stated to be always or usually present during rounds. In contrast, physiotherapists, respiratory therapists or medical specialists such as pharmacists or microbiologist were not regular members of the rounding team on most ICUs. In the majority of cases, the participants reported examining the medical chart directly before or during the bedside visit (84%). An electronic patient data management system (PDMS) was available on 31% of ICUs. Daily goals were always (55%) or usually (39%) set during rounds. Conclusion This survey gives a broad overview of the structure and processes of ICU rounds in different sized hospitals in Germany. Compared to other mostly Anglo-American studies, German ICU rounds appear to be shorter and less interdisciplinary.

Perceptions of Quality of Interprofessional Collaboration, Staff Well-Being and Nonbeneficial Treatment: A Comparison between Nurses and Physicians in Intensive and Palliative Care

“…These meetings are attended by representatives of different professions (physicians, psychologists, nurses, physical therapists, and spiritual caregivers) to discuss achievable treatment goals and the contribution of each profession to achieving these goals. In ICU care, such team conferences are less established and nurses often do not even participate in patient rounds [ 47 ]. Therefore, differences in the perceived quality of interprofessional collaboration could be explained by differences in culture, which are also reflected in aspects of typical structures and processes for coordinating the work of the team.…”

Visual Rounds Based on Multiorgan Point-of-Care Ultrasound in the ICU

“…The critical cognition round ranged from basic clinical scenarios and professional courses to a multidisciplinary round. Rounds play a vital impact on patient safety and quality management in the ICU ( 5 ).…”

Psychosoziale Betreuung auf der Intensivstation

“…Supervision, Fallbesprechungen, Übergaben und auch Rotationen und Vertretungsregelungen können so stabil, flexibel und mit gleichbleibend hoher fachlicher Kompetenz umgesetzt werden [27]. Eine Analyse der ITS-Visiten auf deutschen Intensivstationen macht jedoch deutlich, dass Psycholog*innen bisher noch keine festen Bestandteile der intensivmedizinischen Versorgung sind, obwohl der Bedarf gesehen wird [28,29,30]. ben, das durch eingeschränkte bzw.…”