Document Detail


A nationwide survey of intensive care unit discharge practices.
MedLine Citation:
PMID:  16249927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe intensive care unit (ICU) discharge practices, examine factors associated with physicians' discharge decisions, and explore ICU and hospital characteristics and clinical determinants associated with the discharge process.
DESIGN: Survey in adult ICUs affiliated with the Swiss Society of Intensive Care Medicine.
INTERVENTIONS: Questionnaire inquiring about ICU structure and organization mailed to 73 medical directors. Level of monitoring, intravenous medications, and physiological variables were proposed as elements of discharge decision. Five clinical situations were presented with request to assign a discharge disposition.
MEASUREMENTS AND RESULTS: Fifty-five ICUs participated, representing 75% of adult Swiss ICUs. Responsibility for patient management was assigned in 91% to the ICU team directing patient care. Only 22% of responding centers used written discharge guidelines. One-half of the respondents considered at least 10 of 15 proposed criteria to decide patient discharge. ICUs in central referral hospitals used fewer criteria than community and private hospitals. The availability of intermediate care units was significantly greater in university hospitals. The ICU director's level of experience was not associated with the number of criteria used. In the five clinical scenarios there was wide variation in discharge decision.
CONCLUSIONS: Our data indicate that there is marked heterogeneity in ICUs discharge practices, and that discharge decisions may be influenced by institutional factors. University teaching hospitals had more intermediate care facilities available. Written discharge guidelines were not widely used.
Authors:
Claudia-Paula Heidegger; Miriam M Treggiari; Jacques-André Romand;
Related Documents :
19300087 - Probiotics in the intensive care unit.
12174407 - Expanding a performance improvement initiative in critical care from hospital to system.
12665397 - Propofol: a review of its use in intensive care sedation of adults.
15183217 - The dying patient in the icu: role of the interdisciplinary team.
15658137 - Planning care for non-oncologic terminal illness in advanced age.
24653367 - The gold standards framework: an audit of local practice from a hospice perspective.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-10-26
Journal Detail:
Title:  Intensive care medicine     Volume:  31     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-03-17     Revised Date:  2013-02-07    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1676-82     Citation Subset:  IM    
Affiliation:
Division of Surgical Intensive Care, University Hospital, Rue Micheli-du-Crest 24, 1211, Geneva 14, Switzerland. claudia-paula.heidegger@hcuge.ch
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Critical Care*
Decision Making*
Health Care Surveys
Humans
Intensive Care Units / organization & administration*
Multivariate Analysis
Patient Discharge*
Physician's Practice Patterns*
Practice Guidelines as Topic
Regression Analysis
Switzerland

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Static pressure volume curves and body posture in acute respiratory failure.
Next Document:  Diphtheria, tetanus and pertussis antibodies in 10-year-old children before and after a booster dose...