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ICU Patients Gain From Team Approach to Care

Care from pharmacists, respiratory therapists and an 'intensivist' increases the odds of survival, study finds

MONDAY, Feb. 22 (HealthDay News) -- Intensive care patients are less likely to die if they're looked after by a multidisciplinary health care team that includes doctors, nurses, respiratory therapists, clinical pharmacists and others, says a new study.

Researchers analyzed data from more than 107,000 patients admitted to intensive care units at 112 acute care hospitals in the United States between 2004 and 2006. The risk of death was lower among patients in ICUs where a multidisciplinary team conducted daily rounds.

The lowest risk of death was among patients at the 22 (19.6 percent) hospitals that had a trained intensivist physician who consulted on or managed all ICU cases as well as daily rounds conducted by a multidisciplinary care team.

Care by a multidisciplinary team may reduce the risk of death among ICU patients for a number of reasons, said Michelle M. Kim, of the University of Pennsylvania in Philadelphia, and colleagues.

"Multidisciplinary rounds may facilitate implementation of best clinical practices, such as evidence-based treatments for acute lung injury, sepsis and prevention of ICU complications," they wrote. "Pharmacist participation on rounds is associated with fewer adverse drug events and alone may be associated with lower mortality among ICU patients. Multidisciplinary rounds may also improve communication between health care providers."

The findings may influence how hospitals look after ICU patients, who are often at high risk of death from conditions such as sepsis and acute lung injury.

"Based on these results and expert opinion voiced in consensus guidelines, it is reasonable for hospitals to implement routine multidisciplinary rounds when staffing capabilities allow," Kim and colleagues wrote. "Our study shows that hospitals without the ability to implement high-intensity physician staffing can still achieve significant mortality reductions by implementing a multidisciplinary, team-based approach."

The study appears in the Feb. 22 issue of the journal Archives of Internal Medicine.

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The Society of Critical Care Medicine has more about critical care.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, Feb. 22, 2010

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