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Perception of inappropriate care frequent among ICU workers
Date:12/27/2011

CHICAGO A survey of nurses and physicians in intensive care units (ICUs) in Europe and Israel indicated that the perception of inappropriate care, such as excess intensity of care for a patient, was common, and that these perceptions were associated with inadequate decision sharing, communication and job autonomy, according to a study in the December 28 issue of JAMA.

"Clinicians perceive the care they provide as inappropriate when they feel that it clashes with their personal beliefs and/or professional knowledge. Intensive care unit workers who provide care perceived as inappropriate experience acute moral distress and are at risk for burnout. This situation may jeopardize the quality of care and increase staff turnover," according to background information in the article. The extent of perceived inappropriateness of care in the ICU is unknown.

Ruth D. Piers, M.D., of Ghent University Hospital, Gent, Belgium, and colleagues conducted a study to determine the prevalence and characteristics of perceived inappropriateness of care among clinicians in ICUs. The study consisted of an evaluation on May 11, 2010, of 82 adult ICUs in 9 European countries and Israel. The participants were 1,953 ICU nurses and physicians providing bedside care, who were surveyed regarding perceived inappropriateness of care, defined as a specific patient-care situation in which the clinician acts in a manner contrary to his or her personal and professional beliefs.

Of the 1,651 clinicians who provided responses, 439 (27 percent) reported perceived inappropriateness of care in at least 1 patient. Of the 1,218 nurses who completed the perceived inappropriateness of care questionnaire, 300 (25 percent) reported perceived inappropriateness of care. Of the 407 ICU physicians who provided care, 132 (32 percent) reported perceived inappropriateness of care in at least 1 of their patients.

In all, 397 clinicians completed 445 perceived inappropriate
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Contact: Ruth D. Piers, M.D.
ruth.piers@ugent.be
JAMA and Archives Journals
Source:Eurekalert

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