Table 3.
Intervention | Median Incompatibility1 |
Median Harm2 |
Median Foreseeability3 |
Total score4 |
---|---|---|---|---|
Renal replacement therapy or CVVH | 7 | 8 | 5 | 20 |
Nasogastric tube | 7 | 7 | 6 | 20 |
Tracheotomy | 6 | 7 | 6.5 | 19.5 |
Subcutaneous venous port (portacath) | 5 | 7 | 7 | 19 |
Rectal tube fecal management system | 6 | 6 | 7 | 19 |
Endoscopy- upper or lower | 6 | 7 | 5.5 | 18.5 |
Extracorporeal life support (ECLS)6 | 7 | 9 | 2 | 18 |
Endotrachael intubation6 | 7 | 8 | 3 | 18 |
Lumbar puncture | 6 | 7 | 5 | 18 |
Mechanical ventilation via endotracheal tube or tracheostomy6 | 7 | 8 | 2.5 | 17.5 |
Intraaortic balloon pump6 | 7 | 7.5 | 3 | 17.5 |
Chest tube6 | 7 | 7 | 3.5 | 17.5 |
Pulmonary artery catheter | 5 | 7 | 5.5 | 17.5 |
Epidural catheter | 4 | 7 | 6.5 | 17.5 |
Bronchoscopy - rigid or fiberoptic6 | 5 | 7 | 5 | 17 |
Paracentesis6 | 5 | 6 | 6 | 17 |
Echocardiography Transthoracic6 | 5 | 5.5 | 6.5 | 17 |
Arthrocentesis6 | 5 | 5 | 7 | 17 |
Positron emission tomography (PET scan) | 4 | 5 | 8 | 17 |
Prone positioning during mechanical ventilation6 | 6 | 7.5 | 3 | 16.5 |
Abdominal drain gallbladder or other | 4 | 6.5 | 6 | 16.5 |
Sengstaken Blakemore or Minnesota tube6 | 7 | 8 | 1 | 16 |
Intracranial pressure monitoring subdural or intraventricular6 | 6 | 7 | 3 | 16 |
Intraosseous or intravenous IO or IV access6 | 6 | 6 | 4 | 16 |
Thoracocentesis | 4 | 6 | 6 | 16 |
Nuclear medicine scan (ventilation-perfusion scan) | 4 | 5.5 | 6.5 | 16 |
Foley catheter6 | 5 | 5 | 6 | 16 |
Jugular bulb oximetry6 | 5 | 6.5 | 4 | 15.5 |
Defibrillation cardioversion6 | 6 | 7 | 2 | 15 |
Invasive cardiac procedures5,6 | 4.5 | 7 | 3.5 | 15 |
Arterial Line - radial or femoral6 | 5 | 6.5 | 3.5 | 15 |
Cricothyrotomy6 | 5 | 8 | 1.5 | 14.5 |
Dialysis catheter temporary | 3 | 7 | 4.5 | 14.5 |
Noninvasive ventilation CPAP or BiPAP6 | 5 | 6 | 3 | 14 |
Peripherally inserted central catheter (PICC line) | 3 | 4 | 7 | 14 |
Isolation | 3.5 | 3.5 | 7 | 14 |
Central Venous Access Tunneled or Non | 4 | 6.5 | 3 | 13.5 |
Magnetic Resonance Imaging (MRI) | 3 | 4 | 6.5 | 13.5 |
Cardiac pacemaker temporary | 4 | 6 | 3 | 13 |
Computed tomography (CT scan) | 4 | 3 | 5.5 | 12.5 |
X-ray | 3 | 2.5 | 7 | 12.5 |
Electroencephalography (EEG) | 3 | 3 | 6 | 12 |
Skin suturing | 3 | 3 | 3 | 9 |
Abbreviations: BiPAP, Bilevel positive airway pressure; CPAP, continuous positive airway pressure; CVVH, continuous venovenous hemofiltration.
Response to the statement: “The intervention is potentially incompatible with ≥1 common patient goals.”
Response to the statement: “The intervention is potentially physically, emotionally, or financially harmful.”
Response to the statement: “The intervention can be anticipated on a non-emergent basis.”
Agreement with each criteria rated using a 9-point Likert scale (1, Strongly Disagree; 9, Strongly Agree). Total score is the sum of the median rating for 3 criteria. Interventions highlighted in blue met the standard for inclusion in Round 3: Total score>17 and median rating ≥5 on all criteria.
Includes pericariocentesis and angiography
These interventions received a median rating ≥5 on incompatibility and harm but not foreseeability.