Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Introduction
- Barriers to Best Practice
- Ward Round Structure
- Other Housekeeping Issues
- Conclusion
- Epidemiology of Infection in the ICU
- Mechanisms of Infection in the ICU
- Approach to Infection Control
- Prevention of Infection in the ICU
- Why Assess Perioperative Risk?
- How Do We Identify High-Risk Patients?
- Population-Based Risk Scores
- Individualised Risk Prediction Models
- Objective Functional Capacity Assessment
- Biomarkers
- Assessment of Frailty
- Limitations of Scoring Systems
- Introduction
- Validity
- Scoring Systems
- Considerations and Limitations
- Disease-Specific Scoring systems
- Introduction
- The Responsibility Spiral
- The Lead Clinician/Clinical Director
- The Importance of Communication in ICU
- Effective Communication with Patients and Their Representatives
- Maintaining Accurate, Legible Legal records
- Teamwork and Collaboration
- Ensuring Continuity of Care through Effective Handover of Clinical Information
- Supporting Clinical Staff outside ICU and Contribution of Appropriate Supervision, Training and Delegation
- Introduction
- Capacity
- Consent
- Best Interests
- Conflict Resolution
- Introduction
- Assessment of Capacity
- Competent Adults
- Adults who Lack Capacity
- Advance Care Plans
- Prolonged Disorders of Consciousness
- Do Not Attempt Cardiopulmonary Resuscitation
- Futile Medical Treatment
- Gross Negligence Manslaughter
- Resources and Rationing
- Introduction
- What Is CoBaTrICE?
- Educational Approaches
- Integration in Clinical Practice
- Conclusion
- 11.1 Leading the Daily Intensive Care Ward Round
- 11.2 Principles and Compliance with Local Infection Control Measures
- 11.3 Principles of Outcome Prediction, Prognostic Indicators and Treatment Intensity Scales and Limitations of Scoring Systems in Predicting Individual Patient Outcome
- 11.4 Scoring Systems for Severity of Illness in Critical Care
- 11.5 Managerial and Administrative Responsibilities of the Intensive Care Medicine Specialist
- 11.6 Communication in Intensive Care
- 11.7 Professional Relationships with Members of the Healthcare Team
- 11.8 Legal and Ethical Issues in Intensive Care
- 11.9 The Legal Framework
- 11.10 CoBaTrICE: The Importance of Learning Opportunities and Integration of New Knowledge in Clinical Practice
- Index
- References
11.1 - Leading the Daily Intensive Care Ward Round
from Section 11 - Professionalism, Patient Safety, Governance and Health Systems Management
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Introduction
- Barriers to Best Practice
- Ward Round Structure
- Other Housekeeping Issues
- Conclusion
- Epidemiology of Infection in the ICU
- Mechanisms of Infection in the ICU
- Approach to Infection Control
- Prevention of Infection in the ICU
- Why Assess Perioperative Risk?
- How Do We Identify High-Risk Patients?
- Population-Based Risk Scores
- Individualised Risk Prediction Models
- Objective Functional Capacity Assessment
- Biomarkers
- Assessment of Frailty
- Limitations of Scoring Systems
- Introduction
- Validity
- Scoring Systems
- Considerations and Limitations
- Disease-Specific Scoring systems
- Introduction
- The Responsibility Spiral
- The Lead Clinician/Clinical Director
- The Importance of Communication in ICU
- Effective Communication with Patients and Their Representatives
- Maintaining Accurate, Legible Legal records
- Teamwork and Collaboration
- Ensuring Continuity of Care through Effective Handover of Clinical Information
- Supporting Clinical Staff outside ICU and Contribution of Appropriate Supervision, Training and Delegation
- Introduction
- Capacity
- Consent
- Best Interests
- Conflict Resolution
- Introduction
- Assessment of Capacity
- Competent Adults
- Adults who Lack Capacity
- Advance Care Plans
- Prolonged Disorders of Consciousness
- Do Not Attempt Cardiopulmonary Resuscitation
- Futile Medical Treatment
- Gross Negligence Manslaughter
- Resources and Rationing
- Introduction
- What Is CoBaTrICE?
- Educational Approaches
- Integration in Clinical Practice
- Conclusion
- 11.1 Leading the Daily Intensive Care Ward Round
- 11.2 Principles and Compliance with Local Infection Control Measures
- 11.3 Principles of Outcome Prediction, Prognostic Indicators and Treatment Intensity Scales and Limitations of Scoring Systems in Predicting Individual Patient Outcome
- 11.4 Scoring Systems for Severity of Illness in Critical Care
- 11.5 Managerial and Administrative Responsibilities of the Intensive Care Medicine Specialist
- 11.6 Communication in Intensive Care
- 11.7 Professional Relationships with Members of the Healthcare Team
- 11.8 Legal and Ethical Issues in Intensive Care
- 11.9 The Legal Framework
- 11.10 CoBaTrICE: The Importance of Learning Opportunities and Integration of New Knowledge in Clinical Practice
- Index
- References
Summary
Key Learning Points
1. Insight into habitual barriers leads to an effective ward round.
2. The importance of location, which should be at the bedside, with the patient at the focus.
3. The importance of a structured approach, physical examination, checklists and goal setting.
4. The ward round should be multidisciplinary, promoting a culture of collaborative input, with all individual roles acknowledged and respected.
5. The ward round should be concluded by clarification of agreed goals for the day, defining individual responsibilities within the attending team and contemporaneous documentation.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 739 - 743Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Lane, D, Ferri, M, Lemaire, J, Mclaughlin, K, Stelfox, H. A systematic review of evidence-informed practices for patient care rounds in the ICU. Crit Care Med 2013;41:2015–29.CrossRefGoogle ScholarPubMed
Leape, L, Cullen, D, Clapp, M, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA 1999;281:267–70.Google Scholar
Morrison, C, Jones, M, Blackwell, A, Vuylsteke, A. Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff. Crit Care 2008;12:R148.CrossRefGoogle Scholar
Royal College of Physicians, Royal College of Nursing. 2012. Ward rounds in medicine –principles for best practice. www.colleaga.org/tools/ward-rounds-medicine-principles-best-practiceGoogle Scholar
Royal College of Physicians, Royal College of Nursing. 2021. Modern ward rounds. www.rcplondon.ac.uk/projects/outputs/modern-ward-roundsGoogle Scholar
Vincent, JL. Give your patient a fast hug (at least) once a day. Crit Care Med 2005;33:1225–9.CrossRefGoogle Scholar