Turning a fasthug  into low flat hugs could improve compliance with daily care bundles on the general intensive care unit: a preliminary audit
© Brooke et al.; 2015
Published: 1 October 2015
Over recent years, Intensive Care Medicine has recognised the benefit of implementing checklists to augment strategies for improving patient safety. One such care bundle checklist is the FASTHUG mnemonic (Feeding; Analgesia; Sedation; Thromboprophylaxis; Head up positioning; Ulcer Protection and Glucose levels). In our ICU a variation of the mnemonic has evolved, initially into 'FLATHUGS', and more recently into 'FLATHUGS VC', where additional care bundle components include L: invasive vascular L ines; C: C hlorhexidine mouth care; V: lung protective V entilation.
This clinical audit examines (i) compliance with a locally adapted version of the FASTHUG mnemonic, and (ii)suggests an updated version and template to improve its clinical utility.
A random convenience sample of medical notes from 92 separate patient day reviews over a 4 week period were analysed for documented versions of FLATHUGS VC. Data was collected from all patients with an ICU stay >24 hours, and any actions raised during the documentation of FLATHUGS were checked for completion within that same 24 hour period.
In our unit, a basic 'FLATHUGS' package was completed in 81.5% of cases. The two most recently introduced components in addition to FLATHUGS (lung protective ventilation; and Chlorhexidine mouth care) were documented in 38% and 3.3% of cases respectively (Table 1). In addition, we found there were inconsistencies in the detail of what was recorded under each heading. Common examples included: (i) recording either the type of sedation, or the level of sedation (RASS Score); (ii) date of IV line insertion or anticipated date of IV line replacement.
Completion of FLATHUGS (and variant).
Patient Day Reviews
´FLATHUGS´ attempted but not completed
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