Abstract

Futile care in critical care settings creates ethical dilemmas and places emotional, physical, and financial burdens on patients and healthcare systems. The BRIDGE-ICU algorithm was developed to address these challenges by aligning ICU interventions with patient prognosis and goals-of-care early in the ICU admission process. This quality improvement project, conducted in a 12-bed medical ICU, aimed to reduce the incidence of non-beneficial care through interdisciplinary collaboration and early structured conversations. Patients flagged for potentially futile care were identified by the interdisciplinary care team based on clinical indicators and prognosis. Data collected over two months showed a significant 22.69% reduction in patients receiving futile interventions post-implementation (p = 0.045). The BRIDGE-ICU algorithm promotes early goals-of-care discussions centered on prognosis and functional outcomes, ensuring that care aligns with patient values while enhancing resource efficiency. This project demonstrates the value of practical, outcome-driven approaches in ICU settings, offering a reproducible model for critical care teams aiming to reduce non-beneficial treatments. Implications for the nursing profession include a stronger emphasis on interdisciplinary communication, ethical care delivery, and improving patient-centered outcomes.

Description

The novel BRIDGE-ICU algorithm, developed to reduce futile care, aligns ICU interventions with patient prognosis and goals through early interdisciplinary conversations. A 22.69% reduction in non-beneficial interventions was achieved, demonstrating the algorithm’s effectiveness in critical care. Structured goals-of-care discussions, focusing on functional goals and quality-of-life, enhance ethical decision-making and improve patient outcomes.

Author Details

Bryan Frankovitch, DNP, APRN, ACNPC-AG, CCRN-CMC; Kristin Bott, DNP, APRN, ACNP-BC; Joy Elwell, DNP, FNP-BC, APRN, CNE, FAAN, FAANP; Anna-Rae Montano, PhD, RN, MEDSURG-BC, OCN

Sigma Membership

Mu

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Acute care, Instrument and Tool Development, Interprofessional, Interdisciplinary, Critical Care Burdens

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

Additional Files

References.pdf (58 kB)

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BRIDGE-ICU: A Novel Approach to Reducing Futile Care Through Early Goal Alignment in Critical Care

Seattle, Washington, USA

Futile care in critical care settings creates ethical dilemmas and places emotional, physical, and financial burdens on patients and healthcare systems. The BRIDGE-ICU algorithm was developed to address these challenges by aligning ICU interventions with patient prognosis and goals-of-care early in the ICU admission process. This quality improvement project, conducted in a 12-bed medical ICU, aimed to reduce the incidence of non-beneficial care through interdisciplinary collaboration and early structured conversations. Patients flagged for potentially futile care were identified by the interdisciplinary care team based on clinical indicators and prognosis. Data collected over two months showed a significant 22.69% reduction in patients receiving futile interventions post-implementation (p = 0.045). The BRIDGE-ICU algorithm promotes early goals-of-care discussions centered on prognosis and functional outcomes, ensuring that care aligns with patient values while enhancing resource efficiency. This project demonstrates the value of practical, outcome-driven approaches in ICU settings, offering a reproducible model for critical care teams aiming to reduce non-beneficial treatments. Implications for the nursing profession include a stronger emphasis on interdisciplinary communication, ethical care delivery, and improving patient-centered outcomes.