Patterns of interactions among ICU interprofessional teams: A prospective patient-shift-level survey approach.

Autor: Ratliff HC; School of Nursing, University of Michigan, Ann Arbor, MI, United States of America., Yakusheva O; School of Nursing, University of Michigan, Ann Arbor, MI, United States of America.; School of Public Health, University of Michigan, Ann Arbor, MI, United States of America., Boltey EM; VA Pittsburgh Healthcare System, Pittsburgh, PA, United States of America., Marriott DJ; School of Nursing, University of Michigan, Ann Arbor, MI, United States of America., Costa DK; School of Nursing, Yale University, West Haven, CT, United States of America.; Section of Pulmonary, Critical Care & Sleep Medicine, School of Medicine, Yale University, New Haven, CT, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Apr 16; Vol. 19 (4), pp. e0298586. Date of Electronic Publication: 2024 Apr 16 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0298586
Abstrakt: Background: The Awakening, Breathing Coordination, Delirium monitoring and Early mobility bundle (ABCDE) is associated with lower mortality for intensive care unit (ICU) patients. However, efforts to improve ABCDE are variably successful, possibly due to lack of clarity about who are the team members interacting when caring for each patient, each shift. Lack of patient shift-level information regarding who is interacting with whom limits the ability to tailor interventions to the specific ICU team to improve ABCDE.
Objective: Determine the number and types of individuals (i.e., clinicians and family members) interacting in the care of mechanically ventilated (MV) patients, as reported by the patients' assigned physician, nurse, and respiratory therapist (RT) each shift, using a network science lens.
Methods: We conducted a prospective, patient-shift-level survey in 2 medical ICUs. For each patient, we surveyed the assigned physician, nurse, and RT each day and night shift about who they interacted with when providing ABCDE for each patient-shift. We determined the number and types of interactions, reported by physicians, nurses, and RTs and day versus night shift.
Results: From 1558 surveys from 404 clinicians who cared for 169 patients over 166 shifts (65% response rate), clinicians reported interacting with 2.6 individuals each shift (physicians: 2.65, nurses: 3.33, RTs: 1.86); this was fewer on night shift compared to day shift (1.99 versus 3.02). Most frequent interactions were with the bedside nurse, attending, resident, intern, and RT; family member interactions were reported in less than 1 in 5 surveys (12.2% of physician surveys, 19.7% of nurse surveys, 4.9% of RT surveys).
Interpretation: Clinicians reported interacting with 3-4 clinicians each shift, and fewer on nights. Nurses interacted with the most clincians and family members. Interventions targeting shift-level teams, focusing on nurses and family members, may be a way to improve ABCDE delivery and ICU teamwork.
Competing Interests: Authors have declared that no competing interests exist.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze: MEDLINE
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