02718nas a2200349   4500000000100000008004100001653001100042653001100053653000900064653000900073653001600082653002800098653001400126653001600140653002400156653002400180653002500204653003700229653003600266100001700302700001300319700001500332700002000347700001400367700001400381700001100395245011800406300001100524490000700535520181200542022001402354       2011                            d10aFemale10aHumans10aAged10aMale10aMiddle Aged10aCross-Sectional Studies10aAustralia10aNew Zealand10aGuideline Adherence10aHealth Care Surveys10aIntensive Care Units10aProcess Assessment (Health Care)10aQuality Indicators, Health Care1 aGlass Parisa1 aTaylor C1 aSeppelt I.1 aHewson-Conroy K1 aBurrell A1 aElliott D1 aWebb S00aCompliance with processes of care in intensive care units in Australia and New Zealand--a point prevalence study.  a926-350 v393 a<p>
There are indications that compliance with routine clinical practices in intensive care units (ICU) varies widely internationally, but it is currently unknown whether this is the case throughout Australia and New Zealand. A one-day point prevalence study measured the prevalence of routine care processes being delivered in Australian and New Zealand ICUs including the assessment and/or management of: nutrition, pain, sedation, weaning from mechanical ventilation, head of bed elevation, deep venous thrombosis prophylaxis, stress ulcer prophylaxis, blood glucose, pressure areas and bowel action. Using a sample of 50 adult ICUs, prevalence data were collected for 662 patients with a median age of 65 years and a median Acute Physiology and Chronic Health Evaluation II score of 18. Wide variations in compliance were evident in several care components including: assessment of nutritional goals (74%, interquartile range [IQR] 51 to 89%), pain score (35%, IQR 17 to 62%), sedation score (89%, IQR 50 to 100%); care of ventilated patients e.g. head of bed elevation &gt; 30 degrees (33%, IQR 7 to 62%) and setting weaning plans (50%, IQR 28 to 78%); pressure area risk assessment (78%, IQR 18 to 100%) and constipation management plan (43%, IQR 6 to 87%). Care components that were delivered more consistently included nutrition delivery (100%, IQR 100 to 100%), deep venous thrombosis (96%, IQR 89 to 100%) and stress ulcer (90%, IQR 78 to 100%) prophylaxis, and checking blood sugar levels (93%, IQR 88 to 100%). This point prevalence study demonstrated variability in the delivery of 'routine' cares in Australian and New Zealand ICUs. This may be driven in part by lack of consensus on what is best practice in intensive care units, prompting the need for further research in this area.
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