ArticleAnnals of the American Thoracic Society2017
Diffusion of Evidence-based Intensive Care Unit Organizational Practices. A State-Wide Analysis.
Article in Annals of the American Thoracic Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 31 citations in OpenAlex.
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- Among-Hospital Variation in Intensive Care Unit Admission Practices and Associated Outcomes for Patients with Acute Respiratory Failure.Annals of the American Thoracic Society · 2023Article
- A bibliometric and visualized analysis of early mobilization in intensive care unit from 2000 to 2021.Frontiers in neurology · 2022Article
- The Society of Critical Care Medicine at 50 Years: ICU Organization and Management.Critical care medicine · 2021Article
- Prognosticating Outcomes and Nudging Decisions with Electronic Records in the Intensive Care Unit Trial Protocol.Annals of the American Thoracic Society · 2021Article
- The association between self-declared acute care surgery services and critical care resources: Results from a national survey.Journal of critical care · 2020Article
- Do the Right Thing.Chest · 2020Article
- Article
- Determining the Association Between End-of-Life Care Resources and Patient Outcomes in Pennsylvania ICUs.Critical care medicine · 2019Article
- Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.Journal of critical care · 2019Article
- The Association of ICU Acuity With Outcomes of Patients at Low Risk of Dying.Critical care medicine · 2018Article
- Adaptation of the Acute Organ Failure Score for Use in a Medicare Population.Critical care medicine · 2017Article
- Translating evidence into practice in acute respiratory distress syndrome: teamwork, clinical decision support, and behavioral economic interventions.Current opinion in critical care · 2017Review
- Article
- Teamwork in the intensive care unit.The American psychologistReview
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
rationaleSeveral intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown.
objectivesTo assess diffusion of ICU organizational practices across the state of Pennsylvania.
methodsWe conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents). MEASUREMENTS AND MAIN
resultsOf 223 eligible respondents, nurse managers from 136 (61%) medical, surgical, mixed medical-surgical, cardiac, and specialty ICUs in 98 hospitals completed the 2014 survey, compared with 124 of 164 (76%) chief nursing officers in the 2005 survey. In 2014, daytime physician staffing models varied widely, with 23 of 136 (17%) using closed models and 33 (24%) offering no intensivist staffing. Nighttime intensivist staffing was used in 37 (27%) ICUs, 38 (28%) used nonintensivist attending staffing, and 24 (18%) had no nighttime attending physicians. Daily multidisciplinary rounds occurred in 93 (68%) ICUs. Regular participants included clinical pharmacists in 68 of 93 (73%) ICUs, respiratory therapists in 62 (67%), and advanced practitioners in 37 (39%). Patients and family members participated in rounds in 36 (39%) ICUs. Clinical protocols or checklists for mechanically ventilated patients were available in 128 of 133 (96%) ICUs, low tidal volume ventilation for acute respiratory distress syndrome in 54 of 132 (41%) ICUs, prone positioning for severe acute respiratory distress syndrome in 37 of 134 (28%) ICUs, and family meetings in 19 of 134 (14%) ICUs. Among 61 ICUs that responded to both surveys, there was a significant increase in the proportion of ICUs using nighttime in-ICU attending physicians (23 [38%] in 2005 vs. 30 [49%] in 2014; P = 0.006).
conclusionsThe diffusion of evidence-based ICU organizational practices has been variable across the state of Pennsylvania. Only half of Pennsylvania ICUs have intensivists dedicated to the ICU. Variable numbers use clinical protocols for life-saving therapies, and few use structured family engagement strategies. In contrast, the diffusion of non-evidence-based practices, including overnight ICU attending physician staffing, is increasing. Future research should focus on promoting implementation of organizational evidence to promote high-quality ICU care.
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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.