Mutual Agreement Between Providers in Intensive Care Medicine on Patient Care After Interdisciplinary Rounds

Abstract

Purpose:

Insights regarding the results of interdisciplinary communication about patient care are limited. We explored the perceptions of intensivists, junior physicians, and nurses about patient care directly after the interdisciplinary rounds (IDRs) in the intensive care unit (ICU) to determine mutual agreement.

Methods:

A single-center survey study adapted from Pronovost “daily goal sheet” was performed in the ICUs for adults at a university medical center. Participants were intensivists, junior physicians, and ICU nurses. This survey, consisting of 14 items, was obtained directly after IDRs. Descriptive statistics of 90 observations of 30 discussed patient plans were computed. The internal consistency of the survey was measured by Cronbach α.

Results:

Differences between the hypothesized agreement of 90% and the saturated agreement revealed significant differences in 12 of the 14 items between the 3 groups of ICU care providers. Results of the differing agreement between intensivist and junior physicians or ICU nurses and between ICU nurses and junior physicians revealed that intensivists tend to agree more with ICU nurses than they do with the junior physicians. Internal consistency showed α = .74.

Conclusions:

The recommendation of IDRs without mutual agreement in important aspects of patient care hampers safety in daily practice. This study demonstrates that a survey to determine this agreement between the intensivists, junior physicians, and ICU nurses has low agreement, as measured directly after the IDRs.

Keywords

survey interdisciplinary communication critical care decision making observational design

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