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PLoS One. 2018 Aug 22;13(8):e0201524. doi: 10.1371/journal.pone.0201524. eCollection 2018.

Perspectives on strained intensive care unit capacity: A survey of critical care professionals.

Author information

1
Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
2
Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
3
Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada.
4
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
5
Section of Critical Care, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
6
Research Facilitation, Analytics (DIMR), Alberta Health Services, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

Strained intensive care unit (ICU) capacity represents a supply-demand mismatch in ICU care. Limited data have explored health care worker (HCW) perceptions of strain.

METHODS:

Cross-sectional survey of HCW across 16 Alberta ICUs. A web-based questionnaire captured data on demographics, strain definition, and sources, impact and strategies for management.

RESULTS:

658 HCW responded (33%; 95%CI, 32-36%), of which 452 were nurses (69%), 128 allied health (19%), 45 physicians (7%) and 33 administrators (5%). Participants (agreed/strongly agreed: 94%) reported that strain was best defined as "a time-varying imbalance between the supply of available beds, staff and/or resources and the demand to provide high-quality care for patients who may become or who are critically ill"; while some recommended defining "high-quality care", integrating "safety", and families in the definition. Participants reported significant contributors to strain were: "inability to discharge ICU patients due to lack of available ward beds" (97%); "increases in the volume" (89%); and "acuity and complexity of patients requiring ICU support" (88%). Strain was perceived to "increase stress levels in health care providers" (98%); and "burnout in health care providers" (96%). The highest ranked strategies were: "have more consistent and better goals-of-care conversations with patients/families outside of ICU" (95%); and "increase non-acute care beds" (92%).

INTERPRETATION:

Strain is perceived as common. HCW believe precipitants represent a mix of patient-related and operational factors. Strain is thought to have negative implications for quality of care, HCW well-being and workplace environment. Most indicated strategies "outside" of ICU settings were priorities for managing strain.

PMID:
30133479
PMCID:
PMC6104911
DOI:
10.1371/journal.pone.0201524
[Indexed for MEDLINE]
Free PMC Article

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