A study finds healthcare workers sometimes disagree with the appropriateness… (Gary Friedman / Los Angeles…)
Patients admitted to hospital intensive care units need high-tech, high-cost, lifesaving care, but the professionals who tend to them may not always agree with the decisions regarding that care.
A study conducted in Europe and Israel was completed to assess how healthcare workers viewed the "appropriateness" of care in ICUs. Inappropriate care was defined as care that clashes with the healthcare professional's beliefs or professional knowledge. Researchers surveyed 1,651 doctors and nurses.
One-quarter of the nurses said they perceived some inappropriate care in at least one patient as did 32% of the doctors. Their specific complaints most often involved disproportionate care. For example, many thought care was excessive while a smaller number cited cases where care was insufficient.
And 38% of the respondents said they felt other patients would benefit more from ICU care than the present patient.
"The main reason for perceived inappropriateness of care is a mismatch between the level of care and the expected patient outcome, usually in the direction of perceived excess intensity of care," the researchers said.
While the study was performed in other countries, the strong feelings about inappropriate care "may in fact be higher in the United States, where multiple attending physicians and consultants may be involved in care decisions," said the author of a commentary accompanying the study, Dr. Scott D. Halpern of the Agency for Healthcare Research and Quality.
The study presents a troublesome look at intensive care, Halpern said. Such feelings on the part of healthcare workers could translate to job stress and burnout and may degrade the quality of patient care.
The study and commentary were published Tuesday in the Journal of the American Medical Assn.
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