Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Association between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: A cohort study

Dale, CR and Hayden, SJ and Treggiari, MM and Curtis, JR and Seymour, CW and Yanez, ND and Fan, VS (2012) Association between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: A cohort study. Critical Care, 16 (3). ISSN 1364-8535

[img]
Preview
PDF
Published Version
Available under License : See the attached license file.

Download (451kB) | Preview
[img] Plain Text (licence)
Available under License : See the attached license file.

Download (1kB)

Abstract

Introduction: Protocols for the delivery of analgesia, sedation and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniformly used. The extent to which elements of analgesia, sedation and delirium guidelines are incorporated into order sets at hospitals across a geographic area is not known. We hypothesized that both greater hospital volume and membership in a hospital network are associated with greater adherence of order sets to sedation guidelines.Methods: Sedation order sets from all nonfederal hospitals without pediatric designation in Washington State that provided ongoing care to mechanically ventilated patients were collected and their content systematically abstracted. Hospital data were collected from Washington State sources and interviews with ICU leadership in each hospital. An expert-validated score of order set quality was created based on the 2002 four-society guidelines. Clustered multivariable linear regression was used to assess the relationship between hospital characteristics and the order set quality score.Results: Fifty-one Washington State hospitals met the inclusion criteria and all provided order sets. Based on expert consensus, 21 elements were included in the analgesia, sedation and delirium order set quality score. Each element was equally weighted and contributed one point to the score. Hospital order set quality scores ranged from 0 to 19 (median = 8, interquartile range 6 to 14). In multivariable analysis, a greater number of acute care days (P = 0.01) and membership in a larger hospital network (P = 0.01) were independently associated with a greater quality score.Conclusions: Hospital volume and membership in a larger hospital network were independently associated with a higher quality score for ICU analgesia, sedation and delirium order sets. Further research is needed to determine whether greater order-set quality is associated with improved outcomes in the critically ill. The development of critical care networks might be one strategy to improve order set quality scores. © 2012 Dale et al.; licensee BioMed Central Ltd.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Dale, CR
Hayden, SJ
Treggiari, MM
Curtis, JR
Seymour, CWseymourc@pitt.eduSEYMOURC
Yanez, ND
Fan, VS
Date: 18 June 2012
Date Type: Publication
Journal or Publication Title: Critical Care
Volume: 16
Number: 3
DOI or Unique Handle: 10.1186/cc11390
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1364-8535
Date Deposited: 14 Oct 2016 15:41
Last Modified: 05 Feb 2019 07:55
URI: http://d-scholarship.pitt.edu/id/eprint/29877

Metrics

Monthly Views for the past 3 years

Plum Analytics

Altmetric.com


Actions (login required)

View Item View Item