Targeting Improvements in the ICU: Challenges and Solutions
James S. Krinsley, MD, FCCP; Ruth M. Kleinpell, PhD, RN, FCCM Published February 2005, Society of Critical Care Medicine

In part, some of the increased attention to quality improvement practices has resulted from regulatory organizations. A number of recent guidelines specific to the care of acute and critically ill patients have given ICU clinicians specific measures to target. These include the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)’s work on ICU Core Measures, which focus on central-line-associated primary bloodstream infections, ventilator-associated pneumonia prevention through positioning of the patient's head of the bed 30 degrees or more, stress ulcer disease prophylaxis, deep vein thrombosis prophylaxis, ICU length of stay and risk adjusted mortality rates; and the National Quality Forum's endorsement of measures including urinary catheter-associated urinary tract infection, ventilator-associated pneumonia and central line catheter-associated blood stream infection rates for ICU patients.