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Village Library
9 a.m. - 6 p.m.
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Patient Admission and Mechanical Ventilator Allocation Decision-Making Processes by Frontline Medical Professionals in a Japanese ICU During the COVID-19 Pandemic: A Qualitative Study.
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- Author(s): Ishizaki, Sakura; Jindai, Kazuaki; Saito, Hiroki; Oshitani, Hitoshi; Kulstad Gonzalez, Tess
- Source:
Qualitative Health Research; Dec2023, Vol. 33 Issue 14, p1291-1304, 14p- Subject Terms:
EMERGENCY medical service laws; PATIENTS; QUALITATIVE research; GOVERNMENT policy; RESEARCH funding; HOSPITAL admission & discharge; INTERVIEWING; DECISION making; TERTIARY care; INTENSIVE care units; RESEARCH methodology; EMERGENCY nursing; MECHANICAL ventilators; HEALTH care rationing; COVID-19 pandemic - Source:
- Additional Information
- Subject Terms:
- Abstract: During the COVID-19 pandemic, the need to triage COVID-19 patients in ICUs emerged globally. Triage guidelines were established in many countries; however, the actual triage decision-making processes and decisions themselves made by frontline medical providers may not have exactly reflected those guidelines. Despite the need to understand decisions and processes in practice regarding patient ICU admission and mechanical ventilator usage to identify areas of improvement for medical care provision, such research is limited. This qualitative study was conducted to identify the decision-making processes regarding COVID-19 patient ICU admissions and mechanical ventilator allocation by frontline medical providers and issues associated with those processes in an ICU during the COVID-19 pandemic. Semi-structured, in-depth interviews were conducted with ICU physicians and nurses working at an urban tertiary referral hospital in Japan between February and April 2022. Patient characteristics that influenced triage decisions made by physicians and the interaction between physicians, nurses, and senior management staff upon making such decisions are discussed in this article. An implicated issue was the lack of legal support for Japanese physicians to practice withdrawal of life-sustaining treatments even during emergencies. Another issue was the impact of non-clinical forces—likely specific to health emergencies—on physicians' decisions regarding mechanical ventilator allocation, where such forces imposed a significant mental burden on the medical providers. We consider public policy and legal implications for future pandemics. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Qualitative Health Research is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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