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Device Management During ICU to Floor/Ward Transfer of Care
Background, Rationale and Suggested Implementation Strategies
- Transitions between care teams and units create opportunities for communication errors and omissions. Establishing clear guidelines for managing medical devices can reduce these risks.
- Proper device management ensures that patients continue to receive necessary treatments without interruption, supporting effective recovery.
- Effective management and assessment of the continuing need for devices can prevent complications such as device-associated infections and thrombosis.
- Providing structured guidelines ensures that all healthcare providers, including new staff and trainees, are aligned in terms of expectations and responsibilities during patient transfers.
- Create detailed protocols outlining the steps for device management during ICU-to-floor transfers, specifying actions for each type of device and clinical scenario.
- Involve a multidisciplinary team, including ICU and floor/ward nurses, physicians, and allied health professionals, in the development of these protocols to ensure all perspectives are considered.
- Use validated handoff communication tools, such as SBAR (Situation, Background, Assessment, Recommendation) or checklists, to structure communication and ensure detailed information exchange regarding device management.
Resources and Tools
- ATS ICU PAUSE Tools – The ICU Pause program aims to educate health care providers around patient safety in diagnosis at the time of ICU discharge.
- CDC Presentation: Maintenance and Removal of Central Venous Catheters
- Open Critical Care: ICU Rounding Daily Check List
References
- ICU Transfer Summary Consensus Panel. Identifying essential elements to include in Intensive Care Unit to hospital ward transfer summaries: A consensus methodologyJourn of Crit Care 2019.
- Panel identified 63 distinct information elements identified as essential for inclusion in an ICU transfer summary tool to facilitate communication between providers during the transition of patient care from the ICU to a hospital ward.
- Lekshmi, S. et al. Cocreating the ICU-Pause Tool for Intensive Care Unit-Ward Transitions. ATS Scholar 2022.
- Group created a novel, more user-friendly electronic ICU–ward transfer tool, ICU-PAUSE, alongside Internal Medicine trainees.
- Saint, S. et al. Enhancing the Safety of Critically Ill Patients by Reducing Urinary and Central Venous Catheter-related Infections Am J Respir Crit Care Med 2002.
- Evidence-based overview of preventative measures both for CVCs and Urinary Catheter infections.