National survey on the indicators of quality in Bioethics of the SEMICYUC in the departments of Intensive Care Medicine in Spain

Med Intensiva. 2017 Dec;41(9):523-531. doi: 10.1016/j.medin.2017.01.007. Epub 2017 Apr 25.
[Article in English, Spanish]

Abstract

Introduction: Multiple interventions are performed in critical patients admitted to Intensive Care Units (ICUs). This study explores the presence in the daily practice of ICUs of elements related to the 6 bioethics quality indicators of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units, and the participation of their members in the hospital ethics committees.

Materials and methods: A multicenter observational study was carried out, using a survey exploring descriptive aspects of the ICUs, with 25 questions related to bioethics quality indicators, and assessing the participation of ICU members in the hospital ethics committees. The ICUs were classified by size (larger or smaller than 10 beds) and type of hospital (public/private-public concerted center, with/without teaching).

Results: The 68 analyzed surveys revealed: daily informing of the family (97%), carried out in the information room (82%); end-of-life care protocols (44%); life support limitation form (48.43%); and physical containment protocol (40%). Compliance with the informed consent process referred to different procedures is: tracheostomy (92%), vascular procedures (76%), and extrarenal clearance (25%). The presence of ICU members in the hospital ethics committee is currently frequent (69%).

Conclusions: Information supplied to relatives is adequate, although there are ICUs without an information room. Compliance with the informed consent requirements of various procedures is insufficient. The participation of ICU members in the hospital ethics committees is frequent. The results obtained suggest a chance for improvement in the bioethical quality of the ICU.

Keywords: Bioethics; Bioética; Comité de bioética asistencial; Documentos de consentimiento informado; Ethics committee; Indicadores de calidad; Informed consent forms; Intensive Care Units; Quality indicators; Servicios de Medicina Intensiva.

Publication types

  • Observational Study

MeSH terms

  • Advance Directives / ethics
  • Critical Care / ethics*
  • Critical Care / statistics & numerical data
  • Ethics Committees, Clinical
  • Guideline Adherence
  • Health Surveys
  • Hospital Bed Capacity
  • Humans
  • Informed Consent / ethics
  • Intensive Care Units / ethics*
  • Intensive Care Units / statistics & numerical data
  • Life Support Care / ethics
  • Professional-Family Relations / ethics
  • Quality Indicators, Health Care*
  • Restraint, Physical / ethics
  • Societies, Medical / standards
  • Spain
  • Terminal Care / ethics
  • Truth Disclosure / ethics