(430) Awareness, Communication, and Perceptions of Post-Intensive Care Syndrome Among ICU Providers

Tuesday, February 25, 2025

10:00am – 11:00am Eastern Time

Location: Connections Central - RST 01

First Author(s)

Mark L. Rolfsen, MD

Vanderbilt University Medical Center
Nashville, Tennessee, USA

Co-Author(s)

Matthew F. Mart, MD, MSCI

Vanderbilt University Medical Center, Tennessee, United States
CS

Carla M. Sevin, MD

Associate Professor of Medicine
Vanderbilt University Medical Center, and Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS)
Nashville, United States
Lauren E. Ferrante, MD, MHS

Yale University School of Medicine
Guilford, Connecticut, USA
JK

John P. Kress, MD

Professor of Medicine
University of Chicago, United States
Nathan Brummel, MD, MSCI

The Ohio State University Wexner Medical Center
Columbus, USA
RO

Robert L. Owens, MD

Professor of Medicine
University of California, San Diego, United States
AF

Ana Lucia Fuentes, MD

Clinical Fellow
University of California, San Diego, United States
Jaspal Singh, MD, MS, FCCM

Professor of Medicine
Carolinas Medical Center
Charlotte, North Carolina
GM

Gregory Marelich, MD

Chair, Critical Care Medicine
Kaiser Permanente Northern California, United States
SN

Sukhvinder Nagi, MD, PhD

Physician
Kaiser Permanente Northern California, United States
TE

Tom Elasy, MD, MPH

Professor of Medicine
Vanderbilt University Medical Center, United States
JJ

James C. Jackson, PhD, PsyD

Research Professor of Medicine
Vanderbilt University, and Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS)
Nashville, Tennessee, United States
PP

Pratik Pandharipande, MD, FCCM

Professor of Anesthesiology and Surgery, Vice Chair Anesthesiology Faculty Affairs Office
Vanderbilt University Medical Center, and Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS)
Brentwood, Tennessee, United States
MP

Mayur Patel, MD, MPH

Associate Professor of Surgery
Vanderbilt University Medical Center, and Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS), United States
E. Wesley Wesley Ely, MD, MPH, MCCM

Professor of Medicine
Vanderbilt University and Geriatric Research, Education and Clinical Center (GRECC) Service, Department of Veterans Affairs Medical Center
Nashville, Tennessee, United States

Introduction: Millions of people survive critical illness each year, however up to half of these Intensive Care Unit (ICU) Survivors suffer from new or worsening impairments in various domains of health, collectively referred to as the Post Intensive Care Syndrome (PICS). PICS research has increased since the 1990s, but it remains unclear how often ICU providers are discussing PICS with patients and families. A better understanding into current awareness, communication and perceptions of PICS is a crucial step in improving the care of ICU survivors.

Methods: We performed a survey study to evaluate awareness, communication practices, and perceptions of PICS among ICU providers, including registered nurses [RNs], advanced practice providers [APPs], and physicians (fellows and attendings). A brief survey was developed after multiple rounds of feedback from ICU providers and qualitative researchers. This was distributed by an anonymous link sent via email list serves. We used a convenience sample from the list serves accessible to colleagues at different institutions and were unable to track the total number of recipients.

Results: We obtained N=254 responses from medical/surgical ICU providers (110 RNs, 44 APPs, 100 physicians) at 8 U.S. institutions. 54% of RNs, 86% of APPs, and 97% of physicians had previously heard the term Post Intensive Care Syndrome. 33% of RNs, 27% of APPs and 30% of physicians reported discussing any post ICU impairments with patients or families at least half of the time. Among these 3 groups, 22% reported discussing the possibility of cognitive impairment with patients or families at least half of the time. 55% of RNs, 36% of APPs and 40% of physicians either disagreed or strongly disagreed that their ICU considered it important to discuss PICS with patients and families.

Conclusions: This survey-based study suggests that, while awareness of PICS varies among providers, communication of PICS is poor. In particular, cognitive impairment following critical illness, which occurs often in ICU survivors, is uncommonly discussed with patients or families. Limitations of this study include the self-reported nature of the survey and an unknown but likely low response rate. Further work is needed in exploring communication practices and investigating barriers to improvement.