ICU pros : inappropriate care is common

Nurses and physicians in hospital intensive care units in Europe and Israel say the perception of inappropriate care was common, a survey indicated. Dr. Ruth D. Piers of Ghent University Hospital in 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 May 11, 2010, of 82 adult ICUs in nine 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. The study, published in the Journal of the American Medical Association, found of the 1,651 clinicians who provided responses, 27 percent reported perceived inappropriateness of care in at least one patient. Of the 1,218 nurses who completed the perceived inappropriateness of care questionnaire, 25 percent reported perceived inappropriateness of care, while the 407 ICU physicians who provided care, 32 percent reported perceived inappropriateness of care in at least one of their patients. "In conclusion, perceived inappropriateness of care is common among nurses and physicians in ICUs and is significantly associated with an intent to leave the current clinical position, suggesting a major impact on clinician well-being," the study authors said. "Intensive care unit workers who provide care perceived as inappropriate experience acute moral distress and are at risk for burnout."