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Table 4 Results of statements used in the questionnaire (n = 166)

From: Barriers and facilitators to improve safety and efficiency of the ICU discharge process: a mixed methods study

Category

Subcategory

Statement

Agree (%)

Disagree (%)

NAa (%)

P

Attitude

I think that having a checklist to structure the verbal handover is useful.c

153 (92.2)

7 (4.2)

6 (3.6)

P

Attitude

I think that there is room to improve the communication between ICU and general ward.c, g

145 (87.3)

19 (11.4)

2 (1.2)

I

Resources

I experience enough demand from the ward to implement/sustain the consulting ICU nurse position.

138 (83.1)

20 (12.0)

8 (4.8)

O

ICT infrastructure

I think that when making an up-to-date medication overview at ICU discharge a electronic patient file is indispensable. d

130 (78.3)

32 (19.3)

4 (2.4)

I

Utility

I think that there are differences between intensivists in when they deem a patient ready for ICU discharge, because there are no specific ICU discharge criteria.

128 (77.1)

32 (19.3)

6 (3.6)

S

Collaboration

I do sometimes overestimate the possibilities in a general ward.e

124 (74.7)

38 (22.9)

4 (2.4)

S

Leadership

I think that improving the ICU discharge process deserves more attention from the management.e, f

121 (72.9)

40 (24.1)

5 (3.0)

O

Resources

I think that implementing improvement interventions takes a lot of energy and time.

117 (70.5)

46 (27.7)

3 (1.8)

I

Utility

I think it is desirable to set more specific ICU discharge criteria.

115 (69.3)

48 (28.9)

3 (1.8)

I

Feasibility

I think that planning the discharge of an ICU patient 24 h in advance is not feasible in daily practice, because the time between the decision to discharge and actual handover is often less than 24 h.d

109 (65.7)

54 (32.5)

3 (1.8)

O

Resources

A major reason for not performing a verbal handover between physicians is the fact that the ward physician is often not available.

108 (65.1)

50 (30.1)

8 (4.8)

S

Culture

In my experience ward professional do give feedback when the handover to the general ward was suboptimal,

92 (55.4)

68 (41.0)

6 (3.6)

O

Resources

I think that a lack of financial resources is a barrier for implementing improvement interventions.

82 (49.4)

79 (47.6)

5 (3.0)

O

Resources

In my opinion it is organisationally impossible to make step down facilities.d

82 (49.4)

70 (42.2)

14 (8.4)

O

Resources

I think that because of an insufficient nursing staff it is not feasible to monitor post-ICU patient on the wards. b

76 (45.8)

83 (50.0)

7 (4.2)

Sy

Professional associations

I think that relocating ICU tasks to the wards by a consulting ICU nurse is not desirable. c

65 (39.2)

100 (60.2)

1 (0.6)

I

Credibility

I think the ICU discharge criteria as described in the NVIC guideline are sufficiently based on scientific evidence.

62 (37.3)

79 (47.6)

25 (15.1)

I

Utility

I think that the ICU discharge criteria as described in the NVIC guideline are unclear.

58 (34.9)

91 (54.8)

17 (10.2)

P

Attitude

I think that intensivists should be involved in care for ICU patients until they are discharged from the hospital.

43 (25.9)

123 (74.1)

0 (0.0)

I

Credibility

If there is no scientific evidence for an intervention, I think that this intervention should not be implemented into daily practice.

42 (25.3)

123 (74.1)

1 (0.6)

O

Structure

I think that the size of my hospital makes it more difficult to improve the ICU discharge process.c, e, f, g

42 (25.3)

115 (69.3)

9 (5.4)

O

Resources

I think the current nursing staff is not sufficient for introducing a consulting ICU nurse position.

41 (24.7)

117 (70.5)

8 (4.8)

IP

Accessibility

I’ve never seen written ICU discharge criteria in our ICU.c, d

39 (23.5)

124 (74.7)

3 (1.8)

I

Feasibility

I think that performing structured handover takes a lot of time.

34 (20.5)

130 (78.3)

2 (1.2)

I

Credibility

Because little is known about causes of ICU readmissions, we can’t do anything about this problem.

31 (18.7)

134 (80.7)

1 (0.6)

I

Utility

I think it is impossible to set more specific ICU discharge criteria.

30 (18.1)

124 (74.7)

12 (7.2)

P

Attitude

I think that the sickest patient should be the priority of the intensivist. Patients who are almost ready for ICU discharge are of less importance.f

21 (12.7)

143 (86.1)

2 (1.2)

  1. Abbreviations: NA not applicable, P professional, I intervention, O organisational, S social, Sy society, IP implementation process
  2. amissing data was also grouped in this category
  3. bAnswers influenced by gender
  4. cAnswers influenced by age
  5. dAnswers influenced by work experience
  6. eAnswers influenced by hospital type
  7. fAnswers influenced by ICU level
  8. gAnswers influenced by number of ICU beds