The use of common continuous monitoring parameters: a quality indicator for critically ill patients with sepsis.
Sepsis is a common source of morbidity and mortality among critically ill patients, and targeting measures to promote early recognition and treatment of sepsis is at the forefront of many critical care initiatives. Starting formally in 1992, with the publication of the definitions of sepsis, continuous monitoring of several common physiologic parameters, including electrocardiogram, blood pressure, and oxygen saturation, have been advocated as important in the early identification and treatment of patients with sepsis. The descriptive study detailed in this article was conducted to assess the perceptions and clinical continuous physiologic monitoring practices of experienced critical care clinicians with regard to their use of common physiologic monitoring parameters in the care of patients with sepsis. A convenience sample of 100 physicians and 517 nurses completed a 20-item survey assessing perceptions and clinical monitoring practices related to the care of patients with sepsis. Results indicated that the basic parameters of electrocardiogram, invasive blood pressure, pulmonary arterial catheter monitoring, and oxygen saturation all have value in the recognition and treatment of patients with sepsis. The majority of clinicians used these parameters routinely and felt they were necessary for patient care. These results indicate that clinical practice is in concordance with current practice recommendations.
Giuliano
Karen K
KK
Philips Medical Systems, Andover, Mass, USA. karen.giuliano@philips.com
Kleinpell
Ruth
R
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001784:Blood Gas Analysis / Q000592:standards; D001795:Blood Pressure Determination / Q000592:standards; D002983:Clinical Competence; D003422:Critical Care / Q000592:standards*; D004522:Educational Status; D004562:Electrocardiography / Q000592:standards; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D009730:Nursing Assessment; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D017410:Practice Guidelines as Topic; D011669:Pulmonary Wedge Pressure; D019984:Quality Indicators, Health Care; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013781:Texas