Although morning rounds are slightly different from week to week with different attendings, there is a general format that is followed. The resident should give a full presentation for all new patients. For established patients, you should begin by delineating the patient’s current ICU problems, describing any overnight events, then presenting the most current data in a system by system fashion. Your co-resident/NP will be responsible for entering orders/medications, updating the glass doors with daily goals discussed on rounds, and ordering other labs/imaging as determined during rounds.
A Checklist of Unit Goals and Guidelines (CHUGG) is reviewed AFTER THE PATIENT PRESENTATION to ensure all appropriate guidelines for each individual patient are being followed. For this protocol review, two providers must be present (the fellow must be one of the providers). THIS IS MANDATORY FOR ALL PATIENTS ON DAILY AM ROUNDS. The CHUGG does NOT have to be performed on night rounds.
After reviewing the CHUGG, orders are “read back” TO THE BEDSIDE NURSE and the entire ICU team to ensure nothing is missed and to ensure the oncoming team knows all the active issues that require review over the next 24 hours.
Afternoon rounds will occur at the discretion of the day attending and will followup on the morning plans, address events, results, and changes throughout the day and allow for new problem-solving before handing off to the Night ICU team.
In the evening, rounds will run in a similar fashion, typically starting around 20:00-22:00 for both the red and blue services. Start times may be more flexible and will vary at the attending/ fellow‘s discretion. Generally, the night shift should follow through with the day team’s plan unless there are significant changes in patient condition.