Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania
Treating deranged vital signs is a mainstay of critical care throughout the world. In an ICU in a university hospital in Tanzania, the implementation of the Vital Signs Directed Therapy Protocol in 2014 led to an increase in acute treatments for deranged vital signs. The mortality rate for hypotensi...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2020/4819805 |
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| author | Anna Hvarfner Jonas Blixt Carl Otto Schell Markus Castegren Edwin R. Lugazia Moses Mulungu Helena Litorp Tim Baker |
| author_facet | Anna Hvarfner Jonas Blixt Carl Otto Schell Markus Castegren Edwin R. Lugazia Moses Mulungu Helena Litorp Tim Baker |
| author_sort | Anna Hvarfner |
| collection | DOAJ |
| description | Treating deranged vital signs is a mainstay of critical care throughout the world. In an ICU in a university hospital in Tanzania, the implementation of the Vital Signs Directed Therapy Protocol in 2014 led to an increase in acute treatments for deranged vital signs. The mortality rate for hypotensive patients decreased from 92% to 69%. In this study, the aim was to investigate the sustainability of the implementation two years later. An observational, patient-record-based study was conducted in the ICU in August 2016. Data on deranged vital signs and acute treatments were extracted from the patients’ charts. Adherence to the protocol, defined as an acute treatment in the same or subsequent hour following a deranged vital sign, was calculated and compared with before and immediately after implementation. Two-hundred and eighty-nine deranged vital signs were included. Adherence was 29.8% two years after implementation, compared with 16.6% (p<0.001) immediately after implementation and 2.9% (p<0.001) before implementation. Consequently, the implementation of the Vital Signs Directed Therapy Protocol appears to have led to a sustainable increase in the treatment of deranged vital signs. The protocol may have potential to improve patient safety in other settings where critically ill patients are managed. |
| format | Article |
| id | doaj-art-c1057e82f9ff425e86cc71b178f0ebcd |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-c1057e82f9ff425e86cc71b178f0ebcd2025-02-03T06:46:52ZengWileyEmergency Medicine International2090-28402090-28592020-01-01202010.1155/2020/48198054819805Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in TanzaniaAnna Hvarfner0Jonas Blixt1Carl Otto Schell2Markus Castegren3Edwin R. Lugazia4Moses Mulungu5Helena Litorp6Tim Baker7Medical Faculty, Uppsala University, Uppsala, SwedenPerioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, SwedenDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenPerioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, SwedenDepartment of Anaesthesiology, Muhimbili National Hospital, Dar es Salaam, TanzaniaDepartment of Anaesthesiology, Muhimbili National Hospital, Dar es Salaam, TanzaniaDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenPerioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, SwedenTreating deranged vital signs is a mainstay of critical care throughout the world. In an ICU in a university hospital in Tanzania, the implementation of the Vital Signs Directed Therapy Protocol in 2014 led to an increase in acute treatments for deranged vital signs. The mortality rate for hypotensive patients decreased from 92% to 69%. In this study, the aim was to investigate the sustainability of the implementation two years later. An observational, patient-record-based study was conducted in the ICU in August 2016. Data on deranged vital signs and acute treatments were extracted from the patients’ charts. Adherence to the protocol, defined as an acute treatment in the same or subsequent hour following a deranged vital sign, was calculated and compared with before and immediately after implementation. Two-hundred and eighty-nine deranged vital signs were included. Adherence was 29.8% two years after implementation, compared with 16.6% (p<0.001) immediately after implementation and 2.9% (p<0.001) before implementation. Consequently, the implementation of the Vital Signs Directed Therapy Protocol appears to have led to a sustainable increase in the treatment of deranged vital signs. The protocol may have potential to improve patient safety in other settings where critically ill patients are managed.http://dx.doi.org/10.1155/2020/4819805 |
| spellingShingle | Anna Hvarfner Jonas Blixt Carl Otto Schell Markus Castegren Edwin R. Lugazia Moses Mulungu Helena Litorp Tim Baker Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania Emergency Medicine International |
| title | Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania |
| title_full | Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania |
| title_fullStr | Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania |
| title_full_unstemmed | Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania |
| title_short | Vital Signs Directed Therapy for the Critically Ill: Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania |
| title_sort | vital signs directed therapy for the critically ill improved adherence to the treatment protocol two years after implementation in an intensive care unit in tanzania |
| url | http://dx.doi.org/10.1155/2020/4819805 |
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