Decision-making for intensive care unit admissions
Research type
Research Study
Full title
Understanding and improving the decision-making process surrounding admission to the intensive care unit
IRAS ID
160660
Contact name
Christopher Bassford
Contact email
Sponsor organisation
University Hospitals Coventry and Warwickshire NHS Trust
Clinicaltrials.gov Identifier
13/10/14, NIHR funders reference number
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Admission to an intensive care unit (ICU) allows critically ill patients access to life-saving treatments; but this care involves invasive and distressing interventions; and many people admitted to ICU do not survive to go home. For those who do survive, many continue to have serious problems. Given the burdens of ICU therapy and the limited prognosis for many patients, admission to ICU will not be appropriate for everyone. Clinicians must decide whether the benefits of ICU outweigh the burdens or whether palliative care is in the best interests of a particular patient. Determining who might benefit from ICU and who will be harmed is not straightforward. Most patients considered for ICU admission are too ill to make decisions themselves and clinicians must make the difficult practical and ethical judgements on their behalf. Despite the uncertainty and serious consequences of these decisions there is no agreed process for deciding who should be admitted to ICU.
This research will investigate how these decisions are made and how we can improve this process. We will do this by observing the process of decision-making in six hospitals across the Midlands. We will identify current practice and explore the perspectives of those involved through interviews with ICU doctors, doctors referring patients to ICU and patients’ families; seeking their views on how these decisions should be made. This information will be used to develop a questionnaire survey that will be sent to ICU doctors and nurses to further investigate the factors that they consider most important in making these decisions. We will then develop a decision support framework to guide doctors through the decision making process and information for patients and families. We will implement this framework in three NHS trusts to study how it is used and whether it is fulfilling its aims.REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
15/WM/0025
Date of REC Opinion
18 Feb 2015
REC opinion
Further Information Favourable Opinion