Proactive Ethics Intervention to Improve Intensive Care Unit (ICU) Care (PEI)

California Pacific Medical Center Research Institute

Status: Completed

Conditions: Intensive Care Unit Days

Treatments: Behavioral: Proactive Ethics Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT00996814

26.111EXP

Details and patient eligibility

About

The primary aim of the study is to demonstrate the value of a preemptive approach to ethics consultation in an ICU. The investigators hope to answer the question: Will proactive ethics interventions by a skilled and experienced ethicist, participating in treatment discussions with physicians and nurses, as well as discussions with patients/surrogates, improve the quality of ICU care experienced by patients requiring prolonged treatment in the ICU (5 days or longer) by increasing their perceived quality of care and reducing the length of stay in the ICU by non-survivors?

The study is a randomized trial of the use of an ethics consultant to address latent or manifest ethical issues in patients who remain in the ICU for five days or more, as compared to usual care. The investigators are testing the hypothesis that expanding the role of ethics consultations in the ICU to make them proactive will improve the process and outcomes of patient care by shortening the length of stay in non-survivors, and reducing suffering and unwanted and/or unnecessary aggressive treatments.

Enrollment: 386 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult (over 18 years of age)
• Under treatment for five days or more in the ICU

Exclusion criteria

• Under the age of 18
• Non-English Speaking

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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386 participants in 2 patient groups

Proactive Ethics Intervention

Experimental group

Description:

These patients have an ethics consultant involved in their care beginning on the fifth day of treatment in the ICU

Treatment:

Behavioral: Proactive Ethics Intervention

Usual Care

No Intervention group

Description:

These patients receive usual care in the ICU.