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Identification of Post-Intensive Care Syndrome (PICS) in Primary Care

Abstract Background: Post-intensive care syndrome (PICS) occurs in approximately 50% of ICU survivors and increases risk of mortality and hospital readmission while decreasing quality of life. There were no national guidelines for diagnosis or treatment of PICS at the time of the completion of this project. Purpose: The purpose of this project was to increase identification of PICS in the primary care setting by providers. This was accomplished by implementing an educational toolkit and algorithm to better identify patients with PICS and to evaluate the incidence of PICS. Methods: An educational presentation and a survey were presented to the providers at a primary care office in Maryland. An algorithm was applied to each patient seen in the office from October 2020 to February 2021; if the patients were identified by the algorithm to be at risk for PICS, the PICSq was administered in the office by the medical assistants. Results: The data concerning the effect of the education material imply a positive correlation on provider confidence in the diagnosis of PICS. The mean pre-education was 0 on a self-rated scale of 0-5 (SD=0) and the mean pre-education was 3 on a scale of 0-5 (SD=1.155). In the five months of observation and data collection, thirteen patients were identified to be at risk for PICS requiring screening using the PICSq. Conclusion: Provider education about PICS in the primary care setting can increase the rate of identification of PICS. Tools such as the algorithm and the PICSq, in conjunction with increased provider awareness within the primary care setting, promoted a more positive transition following an acute care stay.