Australian critical care : official journal of the Confederation of Australian Critical Care Nurses · 2025
A mixed-method evaluation of the acceptability, appropriateness, and feasibility of using an actionable processes of care checklist for patients with persistent critical illness.
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Istanboulian Laura, Allum Laura, Gilding Anthony J, Quimson-Yeung Kay, Burry Lisa, Dale Craig, Fraser Ian, Rose Louise
Аннотация
BACKGROUND: Patients with persistent critical illness have care priorities distinct from those experiencing acute critical illness. We developed a checklist called "Action 11" incorporating actionable priorities of care for these patients.
OBJECTIVE: The objective of this study was to evaluate the acceptability, appropriateness, and feasibility of using the Action 11 checklist.
METHODS: A convergent mixed-method study was conducted in two units (unit 1 outside critical care; unit 2 inside critical care) of a community hospital in Canada caring for patients with persistent critical illness. The checklist was used daily for 4 weeks and then weekly for 4 weeks. A sample of healthcare providers was recruited to evaluate checklist acceptability, appropriateness, and feasibility using a questionnaire and interviews.
RESULTS: We received 52 questionnaires and conducted 14 interviews (August-November 2022). Of the 52 completed questionnaires, 35 (67%), 42 (81%), and 41 (79%) had a score ≥16 for acceptability, appropriateness, and feasibility, respectively. Of a maximum score of 20, the total mean (standard deviation) scores for acceptability, appropriateness, and feasibility were 16.2 (2.9), 16.7 (2.4) and 17 (2.5), respectively. Participants from unit 1 found the checklist more acceptable (mean difference: 1.7, 95% confidence interval: [0.2-3.29]) and feasible (mean difference: 1.46, 95% confidence interval: [0.09-2.84]) to use than those from unit 2. Qualitative descriptions for acceptability (comprehensive, inclusive, straightforward, prevented omissions in care, and promoted professional accountability), appropriateness (suited patient needs and enabled a personalised, consistent, and collaborative approach to care), and feasibility (embedding into existing rounding, tailored to unit processes, and through leadership support) were also positive; however, they did not explain differences in rated acceptability and feasibility between the two units.
CONCLUSIONS: The Action 11 checklist was perceived as acceptable, appropriate, and feasible to use in units caring for patients with persistent critical illness. A larger-scale evaluation the of the Action 11 checklist exploring its effect on care processes and patient outcomes is recommended.
OBJECTIVE: The objective of this study was to evaluate the acceptability, appropriateness, and feasibility of using the Action 11 checklist.
METHODS: A convergent mixed-method study was conducted in two units (unit 1 outside critical care; unit 2 inside critical care) of a community hospital in Canada caring for patients with persistent critical illness. The checklist was used daily for 4 weeks and then weekly for 4 weeks. A sample of healthcare providers was recruited to evaluate checklist acceptability, appropriateness, and feasibility using a questionnaire and interviews.
RESULTS: We received 52 questionnaires and conducted 14 interviews (August-November 2022). Of the 52 completed questionnaires, 35 (67%), 42 (81%), and 41 (79%) had a score ≥16 for acceptability, appropriateness, and feasibility, respectively. Of a maximum score of 20, the total mean (standard deviation) scores for acceptability, appropriateness, and feasibility were 16.2 (2.9), 16.7 (2.4) and 17 (2.5), respectively. Participants from unit 1 found the checklist more acceptable (mean difference: 1.7, 95% confidence interval: [0.2-3.29]) and feasible (mean difference: 1.46, 95% confidence interval: [0.09-2.84]) to use than those from unit 2. Qualitative descriptions for acceptability (comprehensive, inclusive, straightforward, prevented omissions in care, and promoted professional accountability), appropriateness (suited patient needs and enabled a personalised, consistent, and collaborative approach to care), and feasibility (embedding into existing rounding, tailored to unit processes, and through leadership support) were also positive; however, they did not explain differences in rated acceptability and feasibility between the two units.
CONCLUSIONS: The Action 11 checklist was perceived as acceptable, appropriate, and feasible to use in units caring for patients with persistent critical illness. A larger-scale evaluation the of the Action 11 checklist exploring its effect on care processes and patient outcomes is recommended.