Main Article Content
Abstract
Background: The APACHE IV scoring system is a validated tool for ICU mortality prediction and resource management. However, its underutilization due to staffing and technological constraints reduces its effectiveness in critical care settings.
Objectives: This project aimed to increase timely APACHE IV score completion, improve score accuracy, align actual outcomes with predicted values, and integrate scoring into routine ICU decision-making.
Methods: A prospective, unit-based process improvement project was implemented over four months (Dec 2024–Mar 2025) in the ICU. Interventions included staff training, EMR integration, compliance dashboards, and sepsis subgroup analysis.
Results: Completion rates of APACHE IV within 24 hours improved from 30% to >80%. ALOS remained below predicted ELS across risk categories. Sepsis EMR peaked at 58% in February but declined by 46% in March. ICU mortality and resource utilization trends improved despite persistent staffing challenges.
Conclusion: Timely APACHE IV implementation enhances ICU performance, enabling better outcome prediction and resource planning. Continued education, staffing support, and automation are vital for sustainability.
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References
- 1. Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med. 2006;34(5):1297–1310.
- 2. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207.
- 3. Ministry of Health (Saudi Arabia). National ICU Guidelines for Risk Scoring and Monitoring. Riyadh: MOH; 2023.
- 4. Keegan MT, Gajic O, Afessa B. Severity of illness scoring systems in the ICU. Crit Care Clin. 2011;27(3):453–475.
References
1. Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med. 2006;34(5):1297–1310.
2. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207.
3. Ministry of Health (Saudi Arabia). National ICU Guidelines for Risk Scoring and Monitoring. Riyadh: MOH; 2023.
4. Keegan MT, Gajic O, Afessa B. Severity of illness scoring systems in the ICU. Crit Care Clin. 2011;27(3):453–475.