Checklist During Multidisciplinary Visits for Reduction of Mortality in Intensive Care Units

Summary

CHECKLIST-ICU will be a cluster randomized trial to ascertain whether the use of an intervention including 1) checklists with assessment of daily goals during the multidisciplinary visit, and 2) clinician prompting can reduce in-hospital mortality of patients admitted to intensive care units (ICUs).

The investigators also aim to describe participant ICUs in terms of the standards for intensive care units proposed by the Brazilian National Health Agency (ANVISA).

Conditions

• Critical Care

Interventions

BEHAVIORAL

Daily checklist and clinician prompting

Interventions are: Checklists: The checklists are arranged in a paper notebook (one per patient) with a daily list on each page, as most ICUs do not have electronic health record systems. During the multidisciplinary visit, the checklist items are read aloud by the nurse and answered by participants of the visit. The checklist is applied at least once on all week days preferably in the mornings, although we strongly suggest applying it also on weekend days. Daily Goals and Clinician Prompting: During the clinical discussion of each patient and the application of the checklist, the intensivists write down the daily goals in a standardized form and read them aloud to the team. Every afternoon between 3 and 5 PM, a nurse reviews the daily goals and takes note of any pending items. Subsequently, the nurse prompts the on-call physician, requesting solutions for these pending items.

Sponsors & Collaborators

• Sociedade Hospital Samaritano

  collaborator OTHER

• D'Or Institute for Research and Education

  collaborator OTHER

• Hospital do Coracao

  lead OTHER

Principal Investigators

• Alexandre B Cavalcanti, MD, PhD · Research Institute - Hospital do Coracao

• Fernando Bozza, MD, PhD · D'Or Institute for Research and Education

• Jorge I Salluh, MD, PhD · D'Or Institute for Research and Education

• Flávia Machado, MD, PhD · Federal University of São Paulo

• Edson R Romano, MD · Hospital do Coracao

• Karina Normilio-Silva · Research Institute - Hospital do Coração

• Otavio Berwanger, MD, PhD · Research Institute - Hospital do Coracao

• Patricia Vendramim, R.N. · Hospital Samaritano

• Viviane C Chiattone, RN · Research Institute - Hospital do Coracao

• Helio P Guimaraes, MD, PhD · Research Institute - Hospital do Coracao

• Valquiria P Campagnucci, MD · Research Institute - Hospital do Coracao

• Derek C Angus, MD, PhD · Department of Critical Care Medicine and CRISMA Center. University of Pittsburgh School of Medicine

• Fernanda Carrara, RN · Latin American Sepsis Institute (LASI)

• Juliana Lubarino, RN · Latin American Sepsis Institute (LASI)

• Aline R Sila, RN · D'Or Institute for Research and Education

• Grazielle Viana, RN · D'Or Institute for Research and Education

• Lucas P Damiani, MSc · Research Institute - Hospital do Coracao

• Chung C Chang, PhD · Division of General Internal Medicine at University of Pittsburgh

Study Design

Allocation

RANDOMIZED

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-08-31

Primary Completion

2014-11-30

Completion

2014-11-30

Countries

• Brazil

Study Locations