PURPOSE: Since buy-in of end-users is integral to the success of checklists, we conducted a web-based survey to query physicians regarding the relative importance of individual components of various checklists. We wanted to create an end-user defined minimum set of high utility components which could be used as the basis of a daily ICU checklist.
METHODS: An online survey was sent to all pulmonary/critical care program directors in the US to be forwarded to their faculty and fellows. Twenty common ICU parameters were selected during survey design after analyzing available surveys. We asked respondents to supply demographic information and to rate each item of the daily checklist on a modified Likert four point scale from not important to very important. Respondents were also asked to choose the six most important items they believe should be on any checklist. A mean importance score for each parameter was calculated.
RESULTS: Four hundred and twenty physicians started the survey and 416 (99.04%) completed it. There was a wide variation in respondents’ critical care experience and percentage of time spent in the ICU. Most respondents worked in a medical ICU (93%), although there was significant overlap in other specialty ICUs. The six items with the highest mean importance score were input/output goal, assessment of sedation, deep vein thrombosis (DVT) prophylaxis, assessment of antibiotics, assessment of central lines, and code status. Three hundred seventy-three respondents chose the six most important items in their perception to be essential on any daily checklist. The same six parameters were chosen, although in differing frequency. In descending order, these are: assessment of sedation (68.3%), DVT prophylaxis (57.4%), input/output goal (52.6%), and assessment of central line (49.1%), antibiotic assessment (42.4%), and code status (40.2%).
CONCLUSIONS: In item-by-item rating and by identification of the most important items, the same 6 items were ranked highest. These items are perceived as the important facets of daily ICU management by the end-user.
CLINICAL IMPLICATIONS: Further studies are needed to determine if compliance with these six items lead to improved ICU outcomes.
DISCLOSURE: The following authors have nothing to disclose: Vipul Kumar, Sidharth Bagga, Benjamin Leiby, Bharat Awsare
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