Differences between nurse- and physician-assessed ICU characteristics using a standardized survey

Area of Science:

• Healthcare Management
• Critical Care Medicine
• Survey Research

Background:

• Surveys are commonly used to evaluate intensive care unit (ICU) organizational features for quality enhancement.
• Typically, these surveys target ICU nurse managers and/or physician directors.

Purpose of the Study:

• To determine if significant differences exist between nurse managers' and physician directors' assessments of ICU characteristics using a standardized survey.

Main Methods:

• A previously developed survey was administered to nurse managers and medical directors in adult ICUs.
• The survey assessed interprofessional staffing and evidence-based protocols.
• Differences were examined using McNemar's test, and concordance was evaluated with the kappa statistic.

Main Results:

• Concordance was moderate to almost perfect for physician staffing and interprofessional staffing presence.
• However, concordance was poor for the presence of providers on rounds and protocols for mechanical ventilation liberation, sedation, and central line insertion.

Conclusions:

• Substantial disagreement exists between nurse managers and physician directors regarding ICU characteristics, despite using a standardized survey.
• These discrepancies raise questions about the reliability of surveys for assessing ICU organizational features.
• Differences in assessments may offer valuable insights for future ICU quality improvement projects.