ArticleCritical care (London, England)2015
Perceptions of the appropriateness of care in California adult intensive care units.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review defining non-beneficial and inappropriate end-of-life treatment in patients with non-cancer diagnoses: theoretical development for multi-stakeholder intervention design in acute care settings.BMC palliative care · 2022Pooled it
- Discussing expected long-term quality of life in the ICU: effect on experiences and outcomes of patients, family, and clinicians-a randomized clinical trial.Intensive care medicine · 2025Trial
- Perceived inappropriateness of care among ICU clinicians is associated with burnout and intention to leave the job.Intensive care medicine · 2026Article
- The resuscitation team members' lived experiences regarding futile cardiopulmonary resuscitation in children and newborn infants: A phenomenological study.Scientific reports · 2026Article
- Decision-Making Approaches Used to Limit Potentially Nonbeneficial Life-Prolonging Interventions.JAMA network open · 2026Article
- Turnover intention among intensive care nurses and the influence of the COVID-19 pandemic: a scoping review.Human resources for health · 2025Article
- Article
- Futility considerations in surgical ethics.Annals of medicine and surgery (2012) · 2023Article
- Article
- Addressing Futility: A Practical Approach.Critical care explorations · 2022Review
- Change in inappropriate critical care over time.Journal of critical care · 2020Article
- Appropriateness of intensive care treatments near the end of life during the COVID-19 pandemic.Breathe (Sheffield, England) · 2020Review
- Population Preferences for Treatments When Critically Ill: A Discrete Choice Experiment.The patient · 2020Article
- Back pain occurrence and treatment-seeking behavior among nurses: the role of work-related emotional burden.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2020Article
- Article
- Resource utilisation and description of patients perceived as receiving inappropriate critical care.Intensive & critical care nursing · 2019Article
- The prevalence of perceptions of mismatch between treatment intensity and achievable goals of care in the intensive care unit: a cross-sectional study.Intensive care medicine · 2019Article
- Association of Perceived Futile or Potentially Inappropriate Care With Burnout and Thoughts of Quitting Among Health-Care Providers.The American journal of hospice & palliative care · 2019Article
- Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA.Intensive care medicine · 2018Observational
- Is there a disconnect between what we do and what we should do? A survey of intensive care physicians and nurses in California.Intensive care medicine · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIncreased demand for expensive intensive care unit (ICU) services may contribute to rising health-care costs. A focus on appropriate use may offer a clinically meaningful way of finding the balance. We aimed to determine the extent and characteristics of perceived inappropriate treatment among ICU doctors and nurses, defined as an imbalance between the amount or intensity of treatments being provided and the patient's expected prognosis or wishes.
methodsThis was a cross-sectional study of doctors and nurses providing care to patients in 56 adult ICUs in California between May and August 2013. In total, 1,363 doctors and nurses completed an anonymous electronic survey.
resultsThirty-eight percent of 1,169 respondents (95% confidence interval (CI) 35% to 41%, 51.1% of physicians and 35.8% of nurses) identified at least one patient as receiving inappropriate treatment. Respondents most commonly reported that the amount of treatment provided was disproportionate to the patient's expected prognosis or wishes-325 out of 429 (76%, 95% CI 72% to 80%)--and that treatment was 'too much' in 93% of cases. Factors associated with perceived inappropriateness of treatment were the belief that death in their ICU is seen as a failure (odds ratio (OR) 5.75, 95% CI 2.28 to 14.53, P = 0.000), profession (doctors more than nurses) (OR 2.50, 95% CI 1.58 to 3.97, P = 0.000), lack of collaboration between doctors and nurses (OR 1.84, 95% CI 1.21 to 2.80, P = 0.004), intent to leave their job (OR 1.73, 95% CI 1.18 to 2.55, P = 0.005), and the perceived responsibility to control health-care costs (OR 1.57, 95% CI 1.05 to 2.33, P = 0.026). Providers supported formal communication training (90%, 95% CI 88% to 92%) and mandatory family meetings (89%, 95% CI 87% to 91%) as potential solutions to reduce the provision of inappropriate treatment.
conclusionsDoctors and nurses working in California ICUs frequently perceive treatment to be inappropriate. They also identified measures that could reduce the provision of inappropriate treatment.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.