Socio-Ecologic Perspective: Barriers Complicating Post-Intensive Care Syndrome Mitigation.

Area of Science:

• Critical Care Medicine
• Health Services Research
• Qualitative Health Research

Background:

• Post-intensive care syndrome (PICS) affects survivors with persistent physical, cognitive, and mental health issues.
• Risk factors include prolonged mechanical ventilation, sedation, and immobility, leading to significant life alterations and economic impact.

Purpose of the Study:

• To explore systemic barriers to mitigating and treating PICS within intensive care units (ICUs).
• To understand healthcare providers' perspectives on PICS mitigation challenges in Essex County, NJ.

Main Methods:

• Qualitative study using a grounded theory approach.
• Semi-scripted interviews with 11 healthcare team members across seven ICUs.
• Thematic analysis involving open, axial, and selective coding.

Main Results:

• Healthcare providers recognize PICS risk factors but feel powerless to implement mitigation strategies.
• Lack of institutionalized protocols and frustration bridging the gap between recommendations and practice were significant themes.
• Interpersonal and organizational barriers impede the operationalization of PICS mitigation measures.

Conclusions:

• Education on PICS mitigation barriers for healthcare providers and stakeholders is crucial.
• Addressing identified barriers can potentially alter the current status quo of PICS care.
• Systemic changes are needed to effectively operationalize PICS mitigation strategies.