Chart an ICU round and hand over

Chart a critical-care observation round on the flowsheet - vitals, GCS, ventilation, severity scores, drips, intake and output, nursing - then write and sign the SBAR shift handover.

Each observation round is one line on the ICU flowsheet. Nurses chart rounds through the shift, and hand the patient over in SBAR form at the end of it.

Before you begin

• The patient is in an ICU, CCU or NICU bed. See ICU / CCU / NICU Board.
• Your role needs the critical-care chart permission. See Users & Roles.

Where to find it

Open Intensive care → Work → ICU / CCU / NICU Board and click the patient.

Chart a round

1. Click New Round. Time is filled with now; change it if you chart late.
2. Under Vital Signs, enter HR, BP, RR, SpO₂, Temp, Glucose and Pain. MAP is worked out from the BP.
3. Under Neurological, enter the GCS Total and the Pupils, for example 3mm R.
4. Under Respiratory / Ventilation, choose the Support, the O₂ Device and O₂ Flow, and the Vent Mode with its settings.
5. Check Severity Scores. NEWS2 and qSOFA come from this round. Enter the SOFA organ scores (0–4 each) if your unit uses them.
6. For a cardiac patient, fill in Cardiac Monitoring: the Rhythm and Chest Pain.
7. For a baby, fill in Neonatal: Weight, Apnea count, Incubator Temp, Phototherapy and Feed.
8. Under Infusions / Drips, click Add drip for each infusion: Drug, Conc, Rate, Dose and its Status (Running, Titrate, Held or Stopped).
9. Under Intake / Output, click Add I/O for each fluid in or out, with its Volume.
10. Under Nursing, choose the Position and write the Shift Note.
11. Click Save Round.

The round appears in the flowsheet table, and the tiles update. A high score shows a Deterioration alert: screen for sepsis and escalate.

To correct a round, click Edit on it, change it and click Update Round.

Hand over at the end of the shift

1. Click Handover.
2. Choose Handing over as (Nurse or Doctor), the Shift and the Risk Level.
3. Write the Situation, Background, Assessment and Recommendation.
4. List the Pending Tasks, for example Repeat ABG 14:00, chase cultures.
5. Pick the colleague Taking over.
6. Tick Sign this handover.
7. Click Save Handover.

The handover shows under Shift Handovers on the flowsheet and on Handover (SBAR).

Print the flowsheet

Click Flowsheet in the patient header to print every round.

Common questions

MAP shows auto. It is worked out from the systolic and diastolic BP. You can type your own value.

Do drips carry over to the next round? Each round records the drips at that time. Add or update them on every round.

The patient is ready for the ward. Click Step down, choose the ward bed and sign the handover to the ward team. See ICU / CCU / NICU Board.