Evaluating Existing ICU Screening Tools as Indicators for Mortality and Morbidity

Date of Award/Publication

4-2018

Document Type

Thesis

Degree Name

M.S. in Advanced Practice Nursing

First Supervisor

Heather Mcgrane Minton

Second Supervisor

Nancy Wilk

Abstract

Background: In the setting of critical care, quantitative tools have been implemented not only for detecting severity of illness, such as the NIHSS scales for stroke, but also as screening tools to detect and treat illnesses or syndromes early, such as in the CAM and SIRS screens. Although these tools have been utilized to detect and determine severity of illness, there is little research available that determines the relationship with these screening scores and mortality and morbidity.

Objective: The purpose of this study was to explore if there was a correlation with existing ICU screening tools and increased mortality and morbidity rates.

Method: This study was a retrospective chart review of ICU patients from a

528-bed acute care facility located in upstate NY. Results of sepsis screens, NIH Stroke (NIHSS) scores, Confusion Assessment Method (CAM) screens, in-hospital mortality rates, as well as, hospital discharge with chronic care needs such as dialysis, tracheostomy, feeding tubes, Skilled Nursing Facility (SNF) placement, and referral to palliative care/hospice was collected. Data was analyzed using SPSS software to determine the relationship between scores and mortality and morbidity.

Results: There was a significant difference in the mean SIRS and NIHSS scores for certain morbidity and mortality rates. CAM scores also showed a relationship with morbidity and mortality.

Conclusion: Existing ICU screening tools do have a relationship between mortality and morbidity; however, more research needs to be completed before utilizing these screens as an indicator for prognosis.

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