Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey

• Published in: Journal of evaluation in clinical practice 2014-02, Vol.20 (1), p.48-57
• Main Authors: Bjurling-Sjöberg, Petronella, Jansson, Inger, Wadensten, Barbro, Engström, Gabriella, Pöder, Ulrika
• Format: Article
• Language: English
• Subjects: Anaesthesiology and Intensive Care; Anestesiologi och intensivvård; Caring Sciences; clinical pathways; Critical Pathways - utilization; Evidence-Based Medicine; evidence-based practice; Guideline Adherence; Health Care Research; Humans; Hälso- och sjukvårdsforskning; intensive care; Intensive Care Units - organization & administration; organization; Practice Guidelines as Topic; Prevalence; professional practice; Residence Characteristics; standardized care plans; Sweden; Vårdvetenskap
• ISSN: 1356-1294; 1365-2753; 1365-2753
• DOI: 10.1111/jep.12078

Rationale, aims and objectives To identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents. Methods A descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted. Results CPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied. Conclusions Progress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high‐quality, interprofessional and evidence‐based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed.