Improved rates of best clinical practice adherence seen during tele-ICU intervention
TUESDAY, May 17 (HealthDay News) -- Implementation of a tele-intensive care unit (ICU) intervention is correlated with reduced mortality risk, length of hospital stay, preventable complications rates, and improvements in best practice adherence, according to a study published online May 16 in the Journal of the American Medical Association.
Craig M. Lilly, M.D., from the University of Massachusetts Memorial Medical Center in Worcester, and colleagues examined the association between tele-ICU intervention and hospital mortality, length of stay, and preventable complications in 6,290 adults admitted to seven ICUs (three medical, three surgical, and one mixed cardiovascular) from 2005 to 2007. Best practice adherence, care plan creation, and clinician response times to alarms were evaluated through electronically supported and monitored processes. Severity-adjusted hospital mortality and case-mix were the main outcomes studied.
The investigators found a hospital mortality rate of 13.6 and 11.8 percent in the pre- and post-intervention period, respectively (adjusted odds ratio [OR], 0.40). Compared to the pre-intervention period, the tele-ICU intervention period was correlated with elevated rates of best clinical practice adherence for prevention of deep vein thrombosis (OR, 15.4), stress ulcers (OR, 4.57), and ventilator-associated pneumonia (OR, 2.20), and for cardiovascular protection (OR, 30.7). The tele-ICU intervention period was also correlated with lower preventable complication rates for ventilator-associated pneumonia and catheter-related bloodstream infection (OR, 0.15 and 0.50, respectively), and shorter length of hospital stay (9.8 versus 13.3 days, respectively). Medical, surgical, and cardiovascular ICUs showed similar results.
"A tele-ICU intervention was associated with lower hospital and ICU mortality and shorter hospital and ICU lengths of stay," the authors write.
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