Aligning critical care interventions with patient goals: A modified Delphi study

详细信息    查看全文

• 作者：Alison E. Turnbull ; DVM ; MPH ; PhD^a ; ^b ; ^c ; ^{turnbull@jhmi.edu" class="auth_mail" title="E-mail the corresponding author} ; Sarina K. Sahetya ; MD^b ; Dale M. Needham ; FCPA ; MD ; PhD^a ; ^b ; ^d
• 关键词：Life-sustaining treatments ; Decision-making ; Clinical decision-making ; Delphi technique ; Critical care
• 刊名：Heart & Lung: The Journal of Acute and Critical Care
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：45
• 期：6
• 页码：517-524
• 全文大小：699 K

文摘

To develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require a clear understanding of patients' treatment goals.

Background

A 2016 policy statement from the American Thoracic Society and American College of Critical Care Medicine calls on intensivists to engage in shared decision-making when “making major treatment decisions that may be affected by personal values, goals, and preferences.”

Methods

A three-round modified Delphi consensus process was conducted via a panel of 6 critical care physicians, 6 ICU nurses, 6 former ICU patients, and 6 family members from 6 academic and community-based medical institutions in the U.S. mid-Atlantic region.

Results

Recommendations about 8 interventions achieved consensus among respondents.

Conclusions

Clinical and patient/family participants in a modified Delphi consensus process were able to identify preference-sensitive decisions that should trigger clinicians to clarify patient goals and consider initiating shared decision-making.