976: IMPACT OF ROUNDING CHECKLISTS ON THE OUTCOMES OF PATIENTS ADMITTED TO INTENSIVE CARE UNITS

Introduction: ICU checklists have been widely introduced, despite mixed literature on their effectiveness. The aim of this systematic review and meta-analysis is to evaluate the effectiveness of ICU rounding checklists on patient outcomes (PROSPERO CRD 42022310092). Methods: We searched five electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, and Google Scholar) for primary studies evaluating the effect of ICU rounding checklists compared to no checklists on patient outcomes. Our primary outcome was in-hospital mortality. Additional secondary outcomes included ICU mortality, 30-day mortality, hospital length of stay (LOS), ICU LOS, duration of mechanical ventilation, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), and ventilator-associated pneumonia (VAP). Tertiary outcomes included provider perceptions. Outcome data was extracted and synthesized into a meta-analysis using RevMan. The GRADE methodology was used to assess the certainty of evidence. Results: Out of 6523 studies, we included 29 studies (29239 patients from 28 observational studies and one RCT). ICU rounding checklists commonly included items on sedation (79.3%, 23/29 studies) and central venous line review (75.9%, 22/29 studies). ICU rounding checklists were not associated with improved in-hospital (six studies, 8286 participants, relative risk [RR] 0.88, 95% confidence interval [CI] 0.76-1.03, very low certainty of evidence) or ICU mortality (eight studies, 16682 participants, RR 0.88, 95% CI 0.77-1.02, very low certainty), compared to no checklists. However, checklists were associated with improved 30-day mortality (six studies, 5164 participants, RR 0.86, 95% CI 0.79-0.94, very low certainty). There were no differences in hospital or ICU LOS, duration of mechanical ventilation, or rate of CAUTI, CLABSI, and VAP. Healthcare providers using rounding checklists had improved job satisfaction and perceptions of patient care. Conclusions: Rounding checklists may be associated with reduced 30-day mortality; however, they were not associated with improvements in other patient-related outcomes. Overall, healthcare providers had positive perceptions on checklists. Further research is required into the development of checklist items and evaluation of their effectiveness.