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VOLUME 21 , ISSUE 4 ( 2017 ) > List of Articles


Quality indicators compliance survey in Indian intensive care units

Manimala Surath, Palepu B. N. Gopal, Rahul Amte

Keywords : Critical care, infection control, patient care, quality indicators, survey

Citation Information : Surath M, Gopal PB, Amte R. Quality indicators compliance survey in Indian intensive care units. Indian J Crit Care Med 2017; 21 (4):187-191.

DOI: 10.4103/ijccm.IJCCM_164_15

License: CC BY-ND 3.0

Published Online: 01-04-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Context: The quality of health care and outcomes of Intensive Care Unit (ICU) have been a major subject of discussion in the past decade. Quality indicators in ICUs maintain an order of uniformity and standard care of delivery across ICUs. Aims: In this study, we tried to analyze the percentage compliance of quality indicators in ICU across our country. Methods: Four hundred complete questionnaire forms were collected in two stages by means of conducting a survey and through email responses to the survey questionnaire. Data were tabulated and evaluated in percentage responses. Results: Monitoring of infection control measures such as hand hygiene (77%), monitoring of ICU-acquired infections (>75%), and quality and policy measures (>70%) were promising. Improvements are required in following end-of-life pathways (52%) and staffing patterns in ICU. ICU discharge timings (41%), standardized mortality ratio monitoring (39%), and multidisciplinary rounds (58%) in ICUs are few areas we need to develop further. Conclusion: The future of critical care looks promising with growing number of trained intensivists and hospitals functioning with an average ICU bed strength of 30–40. Such surveys need to be performed regularly to improve the patient care and safety across ICUs.

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  1. Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: A systematic review. JAMA 2002;288:2151-62.
  2. Amaravadi RK, Dimick JB, Pronovost PJ, Lipsett PA. ICU nurse-to-patient ratio is associated with complications and resource use after esophagectomy. Intensive Care Med 2000;26:1857-62.
  3. Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ. Hospital mortality in relation to staff workload: A 4-year study in an adult Intensive-Care Unit. Lancet 2000;356:185-9.
  4. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available from: [Last accessed on 2014 Mar 10].
  5. Bakker J, Damen J, van Zanten AR, Hubben JH. Protocollencommissie nederlandse vereiniging voor intensive care. Admission and discharge criteria for intensive care departments. Ned Tijdschr Geneeskd 2003;147:110-5.
  6. Pittet D, Allegranzi B, Storr J. The WHO clean care is safer care programme: Field-testing to enhance sustainability and spread of hand hygiene improvements. J Infect Public Health 2008;1:4-10.
  7. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme Lancet 2000;356:1307-12.
  8. Sharma R, Sharma M, Koushal V. Hand washing compliance among healthcare staff in Intensive Care Unit (ICU) of a multispecialty hospital of North India. J Hosp Adm 2012;1:27-33.
  9. Dendle C, Martin RD, Cameron DR, Grabsch EA, Mayall BC, Grayson ML, et al. Staphylococcus aureus bacteraemia as a quality indicator for hospital infection control. Med J Aust 2009;191:389-92.
  10. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006;355:2725-32.
  11. The Scottish Intensive Care Society Audit Group. Audit of Critical Care in Scotland 2014, Reporting on 2013. Available from: [Last accessed on 2015 Apr 06].
  12. Wayne JD, Tyagi R, Reinhardt G, Rooney D, Makoul G, Chopra S, et al. Simple standardized patient handoff system that increases accuracy and completeness. J Surg Educ 2008;65:476-85.
  13. Haig KM, Sutton S, Whittington J. SBAR: A shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf 2006;32:167-75.
  14. Roberts SR, Kennerly DA, Keane D, George C. Nutrition support in the Intensive Care Unit. Adequacy, timeliness, and outcomes. Crit Care Nurse 2003;23:49-57.
  15. Doig GS, Heighes PT, Simpson F, Sweetman EA, Davies AR. Early enteral nutrition, provided within 24 h of injury or Intensive Care Unit admission, significantly reduces mortality in critically ill patients: A meta-analysis of randomised controlled trials. Intensive Care Med 2009;35:2018-27.
  16. Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: A systematic review. Crit Care Med 2001;29:2264-70.
  17. Pronovost P, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C. Improving communication in the ICU using daily goals. J Crit Care 2003;18:71-5.
  18. Trim JC, Elliott TS. A review of sharps injuries and preventative strategies. J Hosp Infect 2003;53:237-42.
  19. Health Quality Ontario. Pressure ulcer prevention: An evidence-based analysis. Ont Health Technol Assess Ser 2009;9:1-104.
  20. Myatra SN, Salins N, Iyer S, Macaden SC, Divatia JV, Muckaden M, et al. End-of-life care policy: An integrated care plan for the dying: A Joint Position Statement of the Indian Society of Critical Care Medicine (ISCCM) and the Indian Association of Palliative Care (IAPC). Indian J Crit Care Med 2014;18:615-35.
  21. Goldfrad C, Rowan K. Consequences of discharges from intensive care at night. Lancet 2000;355:1138-42.
  22. Tobin AE, Santamaria JD. After-hours discharges from intensive care are associated with increased mortality. Med J Aust 2006;184:334-7.
  23. Afessa B, Gajic O, Keegan MT. Severity of illness and organ failure assessment in adult Intensive Care Units. Crit Care Clin 2007;23:639-58.
  24. Kim MM, Barnato AE, Angus DC, Fleisher LA, Kahn JM. The effect of multidisciplinary care teams on Intensive Care Unit mortality. Arch Intern Med 2010;170:369-76.
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