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Inappropriate Intensive Care Unit admissions: Nigerian doctors' perception and attitude.

B B Osinaike1, O Olusanya2

  • 1Department of Anaesthesia, University of Ibadan; Department of Anaesthesia, University College Hospital, Ibadan, Oyo State, Nigeria.

Nigerian Journal of Clinical Practice
|November 5, 2016
PubMed
Summary
This summary is machine-generated.

Nigerian doctors perceive inappropriate Intensive Care Unit (ICU) admissions as common, driven by pressure from superiors and referring clinicians. Strategies to manage full ICUs include discharging stable patients and creating more beds.

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Area of Science:

  • Critical Care Medicine
  • Healthcare Management
  • Medical Ethics

Background:

  • Nonclinical factors significantly influence Intensive Care Unit (ICU) admission decisions.
  • Understanding Nigerian doctors' perceptions of inappropriate ICU admissions is crucial for optimizing resource allocation.

Purpose of the Study:

  • To assess Nigerian doctors' perceptions and attitudes regarding inappropriate ICU admissions and requests for admission when the ICU is full.
  • To identify the primary drivers of inappropriate ICU admissions in the Nigerian context.

Main Methods:

  • An anonymous, self-administered questionnaire survey was conducted among doctors in 17 Nigerian University Teaching Hospitals' ICUs.
  • Doctors rated factors influencing ICU admission and actions taken during full ICU scenarios on a 0-5 scale.
  • Data were analyzed using appropriate statistical methods, including Chi-square tests.

Main Results:

  • 96% of 64 surveyed doctors acknowledged inappropriate ICU admissions.
  • Key perceived reasons included pressure from superiors (93.7%), referring clinicians (89.1%), and hospital management (87.5%).
  • When ICUs were full, doctors prioritized discharging stable patients (95.3%) or transferring non-acute patients (70.3%).

Conclusions:

  • Inappropriate ICU admissions are perceived as frequent in Nigeria, largely due to external pressures.
  • Further research is needed to quantify the impact of these admissions on ICU efficiency and patient outcomes.