1. ICU Mortality and morbidity MEETING
Date : Monday 7th– Sunday 20th August 2017
Presenter : T Hensman

2. Agenda Activity Morbidity Mortality Reports NUM CNC
Research Coordinator
Director ICU
Clinical Champions

3. Activity Admissions: # Source Elective # Emergencies # ED: #
Theatre: #
Ward: # (Post MET: #)
External: #

4. Morbidity Readmissions: # Documented Refusals: # CLABSI: # VAE: #
Unplanned extubation : #
Re-intubation: #
Pneumothorax: #
Accidental CVC removal: #
Falls : #
Pressure injuries : #
Code Grey calls: #

5. Issues within 48H of refusal
Options →
“Reasons” →
Not suitable #
Too well #
No beds #
COPY & PASTE THESE THEN ADD ARROWS
Refusals
Died #
Ward #
Options →
“Outcomes” →
Delayed ICU #
Elective surgery cancelled #
IHT #
Source ED #
Ward #
Theatre #
External #
Not suitable #
Reason
No beds #
Too well #
Ward #
Delayed ICU #
Ward #
Ward #
Outcome
↑↑↑↑↑
Example (Delete)
Issues within 48H of refusal
Not suitable: #
No Beds: #
Too well: #
Ward: # Inter-hospital transfer: #
Delayed ICU: # Surgery Cancelled: #
Died : #

6. Mortality Name –Robert Stewart APACHE II 36 APACHE III: 125 ROD: 78.9%
69yoM admitted to hospital 08/08 with acute cholecystitis. PHx: CCF 2ndry to dilated cardiomyopathy, EF 30%, IHD, COPD, PPM, AICD and chronic renal failure.

7. Mortality
09/08: MET Call at 1330 for hypotension (SBP 88). VBG: lactate of 11 Admitted to ICU Commenced on peripheral aramine. Transferred to theatre at Subsequent concern raised by anaesthetics re: suitability for ICU. Accepted for return to ICU and optimization before OT 2nd MET at 1600 in theatre waiting bay for bradycardia (issues with monitoring). Transferred immediately back up to ICU Pacemaker rate increased to : increasing aramine requirements, associated with confusion and hypoxia. Unable to place lines due to agitation. Intubated to facilitate line placement. On maximal supports post intubation Seen by Prof Pennington, for CT and consideration of cholecystostomy.

8. Mortality CT: gall bladder not suitable for percutaneous intervention
Additional complications of coagulopathy and acute kidney impairment
10/08: On maximal vasopressor support
Discussed with family: for end of life care
Extubated 1300

9. Organ and Tissue Donation
Was this patient considered for organ and tissue donation?
Yes
Were they referred to Donate Life Victoria?
What was their AODR1 status? Not registered
Was the family informed of donation potential? Y
Donation outcome? No
1 Australian Organ Donor Registry

10. Issues

11. Reports NUM CNC Research Coordinator Director Administration
Infection Prevention and Control
Allied Health: PT, D, SW, SP, OT
Spotless - Karen

12. Minutes
NUM
CNC
Research Coordinator
Director
Administration

13. Minutes Infection Prevention and Control
Allied Health: PT, D, SW, SP, OT
Administration
Spotless – Karen

14. Clinical Champions Partnering with Consumers: Candy
Infection Prevention & Control: Antoinette, Kym
Medication Safety: Tamara
Patient ID: Annette
Clinical Handover: Carmen
Blood & blood products: Karen Moyle
Pressure Areas: Karena
Deteriorating patient: Jason
Falls: Clare
Quality: Kelly McCuskey, Lauren
Patient Flow Manager: Damien Z, Tess
No Lift: Fran, Gary
Roster: Gary, Cath
Occupational Health and Safety: Judith
Trauma committee: Crista, Annette
Work place culture Jane