Refusal of beds and triage of patients admitted to intensive care units in Brazil: a cross-sectional national survey

Abstract

Objective To obtain data on bed refusal in intensive care units in Brazil and to evaluate the use of triage systems by professionals. Methods A cross-sectional survey. Using the Delphi methodology, a questionnaire was created contemplating the objectives of the study. Physicians and nurses enrolled in the research network of the Associação de Medicina Intensiva Brasileira (AMIBnet) were invited to participate. A web platform (SurveyMonkey ® ) was used to distribute the questionnaire. The variables in this study were measured in categories and expressed as proportions. The chi-square test or Fisher’s exact test was used to verify associations. The significance level was set at 5%. Results In total, 231 professionals answered the questionnaire, representing all regions of the country. The national intensive care units had an occupancy rate of more than 90% always or frequently for 90.8% of the participants. Among the participants, 84.4% had already refused admitting patients to the intensive care unit due to the capacity of the unit. Half of the Brazilian institutions (49.7%) did not have triage protocols for admission to intensive beds. Conclusions Bed refusal due to high occupancy rates is common in Brazilian intensive care units. Even so, half of the services in Brazil do not adopt protocols for triage of beds.

Perceptions of intensive care triage in Australia and New Zealand in 2009 and 2023

“…Previous studies have described a variety of factors affecting decisions about admission or refusal to the ICU [3] , [4] , [5] and availability of beds has been noted as a frequent reason for admission refusal. 6 …”