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From JAMA |

ICU Clinicians' Perceptions of Appropriateness of Care and the Importance of Nurse-Physician Collaboration

Erin K. Kross, MD; J. Randall Curtis, MD, MPH
Arch Intern Med. 2012;172(11):889-890. doi:10.1001/archinternmed.2012.1671.
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Perceptions of appropriateness of care among intensive care unit (ICU) nurses and physicians are potentially important for several reasons. First, clinicians with perceptions of inappropriate care may experience moral distress and be at risk of burnout, which in turn may result in decreased job satisfaction and retention.13 Second, moral distress and burnout among clinicians may be associated with reduced quality of care for patients and families.4 Finally, perceived inappropriate care—if truly inappropriate—may be a burden on the resources of our health care system. In this interesting article, the primary goals of Piers and colleagues5 were to explore the prevalence of perceived inappropriateness of care among clinicians in 82 European and Israeli ICUs and describe the patient-related situations associated with perceived inappropriateness of care and the level of agreement among clinicians concerning perceived inappropriateness of care. Their secondary goal was to evaluate their hypothesis that perceived inappropriateness of care is associated not only with situational factors but also with clinicians' personal characteristics, work-related factors, and their self-reported intent to leave their job.

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