Table 1.

Interventions That Might Be Useful to Mitigate Mental Distress in the ICU Relevant to the Coronavirus Disease 2019 Pandemic

Environmental interventions •Promoting healthy work environment: personal protection equipment training, simulation on donning and doffing •Provide devices/tools to allow for virtual communication with families Communication training, appropriate staffing, meaningful recognition •ICU self-scheduling/time off and hiring extra personal, extra compensation •Limit the maximum number of days worked consecutively, shorter rotations •Support groups •Cognitive-behavioral therapy, institutional absorbing costs Team-based interventions •Team debriefings; “Schwartz rounds,” promoting the use of psychological first aid •Use of structured communication tools; CPR simulation while wearing shields and n-95 masks to enhance understanding and close loop communication •Team-building and interpersonal skills training; purpose focus and recognition of staff’s roles and performance •Regular leadership rounds; “check-ins” and huddles (situational awareness) Practitioner-focused interventions •Stress reduction training •Relaxation techniques •Time management, endorsing mobile Apps that promote time-management •Assertiveness training •Meditation •Work-life balance measures: hobbies, family, and social activities •Self-care measures: ensuring adequate rest, exercise, healthy eating habits Interventions to mitigate risk factors •Palliative care consultations; training on virtual contacts with families •Ethics consultations •Establishing goals of care for every patient in the ICU; advance directives promotion •Family care conferencing within 72 hours of ICU admission, with the use of virtual methods

Adapted from Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies collaborative statement-burnout syndrome in critical care health-care professionals: a call for action. Chest. 2016;150(1):17-26.