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Treatment interference in acutely and critically ill adults
1University of Pennsylvania School of Nursing, Philadelphia, USA.
Summary
Treatment interference, where critically ill patients remove their own medical devices, is a significant clinical issue. Further research is needed to understand patient behaviors and develop prevention strategies.
Area of Science:
- Critical Care Medicine
- Nursing Research
- Patient Safety
Background:
- Treatment interference, defined as the self-removal of technological devices by patients, poses a significant risk in acute and critical care settings.
- Understanding the phenomenon of patients interfering with their own medical treatments is crucial for improving patient outcomes and safety.
Purpose of the Study:
- To comprehensively review the existing literature on treatment interference in acutely or critically ill adults.
- To identify knowledge gaps and propose a multidisciplinary research agenda to address this clinical problem.
Main Methods:
- A systematic literature search was conducted using MEDLINE and CINAHL databases, supplemented by hand searching.
- Keywords included terms related to self-removal, device manipulation, and unplanned extubation in adult patients.
Main Results:
- Literature on treatment interference was categorized into four key areas: maintaining treatment, unplanned extubation, device disruption, and involuntary treatment.
- The search identified a substantial body of work highlighting the clinical significance of this issue.
Conclusions:
- Treatment interference is a complex, multifactorial, and life-threatening problem in critical care.
- Future research should focus on understanding patient attributes, behavioral cues, and consequences to develop effective multidisciplinary prevention strategies.