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The Practice of Respect in the Intensive Care Unit.

Author
Abstract
:

Although "respect" and "dignity" are intuitive concepts, little formal work has addressed their systematic application in the intensive care unit (ICU) setting. After convening a multidisciplinary group of relevant experts, we undertook a review of relevant literature and collaborative discussions focused on the practice of respect in the ICU. We report here the output of this process, including a summary of current knowledge, a conceptual framework, and a research program for understanding and improving the practice of respect and dignity in the ICU. We separate our report into findings and proposals. Findings include: (1) dignity and respect are interrelated; (2) ICU patients and families are vulnerable to disrespect; (3) violations of respect and dignity appear to be common in the ICU and overlap substantially with dehumanization; (4) disrespect may be associated with both primary and secondary harms; (5) systemic barriers complicate understanding and the reliable practice of respect in the ICU. Proposals include (1) initiating and/or expanding a field of research on the practice of respect in the ICU; (2) treating "failures of respect" as analogous to patient safety events and using existing quality and safety mechanisms for improvement; and (3) identifying both benefits and potential unintended consequences of efforts to improve the practice of respect. Respect and dignity are important considerations in the ICU, even as substantial additional research remains to be done.

Year of Publication
:
2018
Journal
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American journal of respiratory and critical care medicine
Date Published
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2018
ISSN Number
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1073-449X
URL
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http://www.atsjournals.org/doi/abs/10.1164/rccm.201708-1676CP?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
DOI
:
10.1164/rccm.201708-1676CP
Short Title
:
Am J Respir Crit Care Med
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