Improving Care in the Intensive Care Unit

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An intensive care unit is an environment for patients who are critically ill. Patients in the ICU are in a very critical condition; therefore, they require very close attention from the nurses. They require bedside nursing because of their conditions. The ICU adverse environmental factors can contribute to increased mortality of increased stay in the hospital (Longest et al., 2008). Some of the factors that contribute to a stressful ICU environment are social isolation, noise, mobility restriction, and noise. Health institutions should find ways of improving the ICU environment so that critically ill patients may be at peace while in the ICU. Bedside nurses also get stressed up because of the daily heavy workload because they have to not only do assessments to the clients but also do personal care like toileting them and bathing them as well. This paper will use two different approaches that can be used to improve the health care quality and safety in Intensive Care Unit. The two approaches are; appreciative inquiry and the SWOT analysis.

Appreciative Inquiry

Appreciative inquiry is an approach used by organizations to improve the quality of services. This approach can also be used in a healthcare setting especially in the intensive care unit to improve the quality healthcare in the ICU. It focuses on a predetermined area of need in the intensive care unit. The process of appreciative inquiry involves a group of nurses who are involved in the ICU department and any other stakeholders who are associated with the ICU. This technique works by identifying strengths in the ICU then uses those strengths to improve on the areas of need (Richer et al., 2010). It assumes that identifying the strengths of an association can help the association to improve and develop the organization. In this case, the first step of the technique is to identify the area of need then follow the four stages to implement it. The area of need, in this case, is improving bedside care in the ICU. The appreciative inquiry then follows its four stages to improve on this objective.

1. Discovery- this stage involves determining the strengths in the bedside care in the ICU. Bedside nurses should be involved to determine their strengths and anything positive about bedside care in the ICU.

2. Dream- at this stage, the body handling the case should indicate what they wish for in the future. For example, in this case, a dream could be reduced workload for bedside nurses, or improved facilities in the ICU.

3. Design- this is the stage where the actual planning and implementation of the change should be done. Those in charge of the process should come up with strategies that can be used to facilitate the change. For example, they can think of assigning a nurse to only one patient to care for instead of one nurse handling several patients, or using noise proof walls in the ICU.

4. Destiny – this stage involves evaluating the change and how to sustain the progress. The change should be evaluated to see if it is effective and that the situation is improved.

SWOT analysis of improving care in the ICU

This is another approach that can be used to improve the quality of care in the ICU by identifying strengths, weaknesses, opportunities, and threats within the ICU department (Porter, 2009).

1. Strengths- these are the available resources and capabilities that can be used to the advantage of the ICU department. Some of the strengths could be

Availability of funds

Special experience

Good reputation

And any other aspects that are advantageous

2. Weaknesses – these are areas than need to be improved. Weaknesses need to be dealt with. They originate from inside. Some of the weaknesses could be;


Negative reputation

Poor location of the facility

Inadequate facilities

Gaps in service areas

3. Opportunities-these are the external available aspects or factors that can be exploited to improve healthcare in the ICU. Some opportunities could be;

Availability of more experienced nurses – the facility should take the advance of the nurses and employ them to assist in the ICU.

Vacant good geographical area – the facility should consider obtaining the vacant land.

4. Threats- these are the stumbling blocks to the success of healthcare. They are mostly external factors. They could be;

Loss of important and experienced staff – this can be eliminated by recruiting new experienced staff

Competitors have better ICU healthcare facilities- this can be eliminated by finding ways in which the facility can acquire the required and the latest facilities

Noise producing factories have been built near the health facility - the facility should consider installing sound-proof walls to counter the noise.

The two approaches are effective in improving the quality care in the ICU. However, the SWOT analysis is the most effective approach because it does not only focus on the strengths but also addresses any possible threats and the present weaknesses that have a great impact on the need (McPeake et al., 2016).  Appreciative inquiry focuses on the strengths available to improve care in the ICU, but it does not address the weaknesses that could be contributing to the situation, or any possible threats that could affect the healthcare in ICU in the future.

For leaders to implement the two approaches effectively, they need to have some leadership skills. They should be open-minded, innovative, have excellent managerial skills, and encourage health manager-staff relations. 


In conclusion, the two approaches are very effective in improving quality of care in the intensive care unit. However, the Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis is the best and most effective approach of the two. It improves the quality of care in ICU at present and in future as well. 


Longest, B. B., Rakich, J. S., & Darr, K. (2008). Managing health services organizations and systems. Baltimore, MD: Health Professions Press.

McPeake, J., Struthers, R., Crawford, R., Devine, H., MacTavish, P., & Quasim, T. (2016). A study to explore the experiences of patient and family volunteers in a critical care environment: a phenomenological analysis.

Porter, M. E. (2009). A strategy for health care reform—toward a value-based system. New England Journal of Medicine,361(2), 109-112.

Richer, M. C., Ritchie, J., & Marchionni, C. (2010). Appreciative inquiry in health care. British Journal of Healthcare Management, 16(4), 164-172.

October 13, 2023

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