ORIGINAL ARTICLE
Potential sources of conflict in intensive care units – a questionnaire study
1
Department of Ethics, Faculty of Medicine, Medical University of Gdańsk, Poland
2
University of Gdańsk, Poland
3
Department of Sociology, Public Affairs and Economy, University of Gdańsk, Poland
4
Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdańsk, Poland
5
Department of Anaesthesiology and Intensive Therapy, Hospital in Malbork, Poland
6
Department of Anaesthesiology and Intensive Therapy, Specialist Hospital in Chojnice, Poland
7
Department of Anaesthesiology and Intensive Therapy, Tczew Hospitals PLC, Poland
8
Department of Anaesthesiology and Intensive Therapy, Specialist Hospital in Kościerzyna, Poland
9
Department of Anaesthesiology and Intensive Therapy, Hospital in Stargard Gdański, Poland
10
Department of Anaesthesiology and Intensive Therapy, Department of Hyperbaric Medicine and Sea Rescue, University Centre for Maritime and Tropical Medicine in Gdynia, Poland
11
Department of Anaesthesiology and Intensive Therapy, Specialist Hospital in Wejherowo, Poland
12
Department of Anaesthesiology and Intensive Therapy, Children’s Hospital in Gdańsk, Poland
13
Department of Anaesthesiology and Intensive Therapy, Regional Hospital in Kartuzy, Poland
14
Department of Anaesthesiology and Intensive Therapy, Regional Specialist Hospital in Słupsk, Poland
15
Department of Anaesthesiology and Intensive Therapy, Hospital in Gdańsk, Poland
Submission date: 2019-09-08
Acceptance date: 2019-09-12
Publication date: 2019-10-29
Anaesthesiol Intensive Ther 2019;51(5):357-360
KEYWORDS
TOPICS
ABSTRACT
Background:
Conflicts occur in intensive care units (ICUs), and an international multicentre study conducted in 2008, including 323 ICUs from 24 European countries, confirmed the occurrence of this phenomenon. There are no data in Poland. The aim of the study was to analyse the frequency of the occurrence of conflicts in ICUs in Polish hospitals, and their most frequent sources.
Methods:
The study was based on an original questionnaire performed in 12 ICUs in the Pomeranian Voivodship. The respondents were asked questions regarding the frequency, type, and lines of conflicts between employees, as well as potential causes of conflicts.
Results:
Completed surveys were received from 232 employees, including 79 doctors and 153 nurses. The phenomenon of occurrence of conflicts was confirmed by about 30% of the staff, providing answer that conflicts occur “often”. About 43% of staff estimated that conflicts “sometimes” occur and 25% chose the answer “rarely”. Analysis of the answers made it possible to identify the most common potential causes of conflict.
Conclusions:
The main sources of conflicts in ICUs appear to be external factors such a financial issues and physical overload. The hospital policy and the health policy of the state are also important. The perceived conflicts require careful and constant monitoring. The frequency of hidden conflicts requires thorough assessment of their impact on the quality of work.
Conflicts occur in intensive care units (ICUs), and an international multicentre study conducted in 2008, including 323 ICUs from 24 European countries, confirmed the occurrence of this phenomenon. There are no data in Poland. The aim of the study was to analyse the frequency of the occurrence of conflicts in ICUs in Polish hospitals, and their most frequent sources.
Methods:
The study was based on an original questionnaire performed in 12 ICUs in the Pomeranian Voivodship. The respondents were asked questions regarding the frequency, type, and lines of conflicts between employees, as well as potential causes of conflicts.
Results:
Completed surveys were received from 232 employees, including 79 doctors and 153 nurses. The phenomenon of occurrence of conflicts was confirmed by about 30% of the staff, providing answer that conflicts occur “often”. About 43% of staff estimated that conflicts “sometimes” occur and 25% chose the answer “rarely”. Analysis of the answers made it possible to identify the most common potential causes of conflict.
Conclusions:
The main sources of conflicts in ICUs appear to be external factors such a financial issues and physical overload. The hospital policy and the health policy of the state are also important. The perceived conflicts require careful and constant monitoring. The frequency of hidden conflicts requires thorough assessment of their impact on the quality of work.
REFERENCES (21)
1.
Azoulay E, Timsit JF, Sprung CL, et al. Prevalence and factors of Department of Anaesthesiology and Intensive Therapy conflicts:.
2.
the conflictus study. Am J Respir Crit Care Med 2009; 180: 853-860. doi: 10.1164/rccm.200810-1614OC.
3.
Wujtewicz M, Wujtewicz MA, Owczuk R. Conflicts in the intensive care unit. Anaesthesiol Intensive Ther 2015; 47: 360-362. doi: 10.5603/AIT.20155.0055.
4.
Strack van Schijndel RJM, Burchardi H. Bench-to-bedside review: leadership and conflict management in the intensive care unit. Crit Care 2007; 11: 234-240.
5.
Luce JM, White DB. A history of ethics and law in the intensive care unit. Crit Care Clin 2009; 25: 221-237. doi: 10.1016/j.ccc.2008.10.002.
6.
Luce J. Conflicts over ethical principles in the intensive care unit. Crit Care Med 1992; 20: 313-315.
7.
Fassier T, Azoulay E. Conflicts and communication gaps in the intensive care unit. Curr Opin Crit Care 2010; 16: 654-665. doi: 10.1097/MCC.0b013e32834044f0.
8.
Luce JM. A history of resolving conflicts over end-of-life care in intensive care units in the United States. Crit Care Med 2010; 38: 1623-1626.
9.
Schuster RA, Hong SY, Arnold RM, et al. Investigating conflict in ICUs – Is the clinicians’ perspective enough? Crit Care Med 2014; 42: 328-335. doi: 10.1097/CCM.0b013e3182a27598.
10.
Kwiecień-Jaguś K, Mędrzycka-Dąbrowska W, Małecka-Dubiela A. Źródła stresu zawodowego a sposoby radzenia sobie w sytuacjach stresogennych pielęgniarek pracujących na wybranych oddziałach szpitalnych – doniesienia wstępne. Pomeranian Life Sci 2018; 64: 53-60.
13.
Rozporządzenie Ministra Zdrowia z dnia 16 grudnia 2016 r. w sprawie standardu organizacyjnego opieki zdrowotnej w dziedzinie anestezjologii i intensywnej terapii. Dz.U. 2016, poz. 2218. Available at: http://dziennikustaw.gov.pl/DU....
14.
Long AC, Curtis JR. The epidemic of physician-family conflict in the ICU and what we should do about it. Crit Care Med 2014; 42: 461-462. doi: 10.1097/CCM.0b013e3182a525b8.
15.
Breen CM, Abernethy AP, Abbott KH, et al. Conflict associated with decisions to limit life-sustaining treatment in intensive care units. J Gen Intern Med 2001; 16: 283-289.
16.
Norton SA, Tilden VP, Tolle SW, et al. Life support withdrawal: communication and conflict. Am J Crit Care 2003; 12: 548-555.
17.
Kübler A, Siewiera J, Durek G, et al. Guidelines regarding the ineffective maintenance of organ functions (futile therapy) in ICU patients incapable of giving informed statements of will. Anaesthesiol Intensive Ther 2014; 46: 215-220. doi: 10.5603/AIT.a2014.0038.
18.
Azoulay E, Sprung CL. Family-physician interactions in the intensive care unit. Crit Care Med 2004; 32: 2323-2328. doi: 10.1097/01.CCM.0000145950.57614.04.
19.
Ervin JN, Kahn JM, Cohen TR, et al. Teamwork in the intensive care unit. America Psychologists 2018; 73: 468-477. doi: http://dx.doi.org/10.1037/amp0....
20.
Piquette D, Reeves S, LeBlanc VR. Stressful intensive care unit medical crises: how individual responses impact on team performance. Crit Care Med 2009; 37: 1251-1255. doi: 10.1097/CCM.0b013e318 19c1496.
21.
Mason V, Leslie G, Clarc K, et al. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses. Dimension of Crit Care Nursing 2014; 33: 215-225. doi: 10.1097/DCC. 0000000000000056.
| eISSN: | 1731-2531 |
| ISSN: | 1642-5758 |
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