To provide an insight into the ethical issues that affect admissions into the ICU as well as the process of discharging, the objective of this research if to explore and identify ethical dilemmas that face professionals in the healthcare sector. The main hypotheses is therefore based on the problems that are ethical in in the admission as well as discharge context in the ICU, which are divided into various problems that concern occupancy in full, of the beds as well as problems that are related to decisions on treatment (Ulrich et al, 2010).
Only few empirical studies into the factors that are non-medical, and affect nurses and physicians in making decisions about the process of discharging and admitting patients in the ICU.Information relating to the healthcare professionals attitude about such process can be utilized in enhancing the process of decision making about intensive care resource allocation. The ICU is an environment of high pressure, where there is delivery of expensive health-care by personnel who are highly to patients that suffer from diseases that are potentially life-threatening (Ulrich et al, 2010).There is limited bed availability, which makes high throughput for patients quite important. Such a throughput usually depends on new patients’ admission as well as discharging to general wards of the ones whose care equipment for ICU is meant to have ended. The societal financial pressure and higher management keeps increasing. Care services that are critical give a representation of a proportion of net hospital costs that keep increasing, up right from 1980’s 8% to the 2006’s 20% in the United States for example. In addition, in Netherlands, ICU department costs have been estimated to give a representation of close to 20% of the total budget for the hospitals. The ICU bed number that is limited as well as the ICU care pressure on the total budget for the hospital, makes it necessary for ICU beds’ optimal use as well as flow of patients from the emergency room, general ward and operating theatre to the ICU and the opposite is applicable (McLeod, 2014).
This study was quite descriptive and explorative at the same time as it used qualitative methods, both focus and individual group interviews. Face to face interviews that are semi-structured are quite useful in exploration of topics that are sensitive in depth. In the focus groups that are subsequent, the interaction and group dynamic among participants helps a greater deal in further exploration as well as clarification of views for participants. Those included nurses and physicians in Dutch hospitals, who work either in the ICU department, or regularly in the general ward through admitting of patients from the ICU (McLeod, 2014).
19 individual interviews were conducted as well as 4 focus group interviews accompanies with physicians and nurses that work in the general ward or ICU of 10 Dutch hospitals. Before the study was started,
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