• Dana Chemali, Nadia Roumeliotis, Caitlyn Cater, Lianne Dulsrud, Lianne Jeffs, Anna Taddio, Helena Frndova, and Christopher Parshuram.
• Department of Critical Care Medicine, Hospital for Sick Children, Toronto, ON, Canada.
• J Crit Care. 2019 Aug 1; 52: 53-57.

PurposeCare in the paediatric intensive care unit (PICU) involves many clinical activities. The objectives of this study were to evaluate the feasibility of a novel observation method, the reliability of data abstraction, and to report the initial findings from application of this approach.Materials And MethodsBedside activities of patients and clinical staff were recorded by direct observational study using video recording and audio annotation. Data were abstracted into 9 broad clinical activities and 12 specific drug-fluid activities. Enrolment rates, agreement between abstractors, clinical activity durations and interruptions are reported.ResultsWe enrolled 42 healthcare professionals, 12 family members of 13 patients, and recorded 12 patients (consent rates of 70%-92%). There were 884 clinical activity episodes. Each hour was comprised of a median (IQR) of 11.9 (4.8-16.5) minutes of drug and fluid related tasks. The 682 drug and fluid related activities were mainly preparation and administration. Interruptions occurred on average 7 times per hour. Data abstraction for 8 h had intra-class correlation co-efficient (95% CI) of 0.91 (079-0.96).ConclusionsReal-time recording of clinical tasks in the PICU using a direct observation model combined with video recording is feasible. Preliminary results suggest abundant and diverse activity is routine.Copyright © 2019. Published by Elsevier Inc.

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