Tag Archives: patient safety

Quality of life and patient safety: The impact of the work environment on the well-being of medical staff in ICU settings

Sebastian Isac1, Elisabeta Nita1, Victor Cristian Toma1, Andrada-Georgiana Badea1, Mihaela Camelia Popa2, Teodora Isac3, Mara Madalina Mihai4, Cristina Veronica Andreescu5, Cristina Martac1, Gabriela Droc1

1 Department of Anesthesiology and Intensive Care I, Fundeni Clinical Institute, Bucharest, Romania
2 Institute of Philosophy and Psychology ˝Constantin Radulescu- Motru˝, Romanian Academy, Bucharest, Romania
3 Department of Internal Medicine II, The Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
4 Department of Oncologic Dermatology and Allergology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
5 Department of Foreign Languages, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

DOI: 10.2478/jccm-2026-0036

Background and aim: Professional Quality of Life (ProQoL) is essential for understanding the well-being of the healthcare professionals working in high-stress environments, such as the intensive care units (ICUs). – This study aimed to assess the influence of age, gender, hospital affiliation, and professional role on the ProQoL dimensions (Compassion Satisfaction – CS, Burnout – BO, Secondary Traumatic Stress – STS) and to analyze the relationship between the perceptions of patient safety (measured via the Safety Attitudes Questionnaire – SAQ) and the professional quality of life.
Method: This cross-sectional observational study included 247 healthcare professionals (April-November 2024) from 20 different hospitals, working in ICUs (nurses, attending physicians, medical residents -, and other staff). Participants filled out the ProQoL and SAQ questionnaires out of which only 10 SAQ items were used. Statistical analyses were performed using ANOVA, t-tests, and Pearson correlation coefficients.
Results: Medical residents and participants in the 20–30 age group reported having the highest burnout scores (28.37 ± 0.37), and the lowest level of compassion satisfaction score (36.65±0.61), while attending physicians had elevated levels of secondary traumatic stress (25.69±0.57). Positive perceptions of the work environment (safety, conflict resolution, workplace satisfaction) were negatively correlated with the burnout (r = –0.5888, p < 0.0001). Finally, the perception of a pleasant job and workplace positively correlates with the CS score (r=0.53 p˂0.0001).
Conclusions: Professional well-being varies significantly in terms of age, and position. These findings suggest that workplace strategies focusing on safety, teamwork, and workload balance may play a role in supporting the ICU staff well-being.

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Percutaneous tracheostomy in Costa Rican intensive care units: Multicenter epidemiology, practices, and immediate complications

Pablo Alvarez-Aguilar1, Leonardo Chacón-Prado2, Dennis Rojas-Quirós2, Oscar Palma-Rodríguez1, Donato Salas-Segura2, TRAQUEOSCR Group

1 Hospital México, Caja Costarricense de Seguro Social, San José, Costa Rica
2 Hospital Rafaél Ángel Calderón Guardia, Caja Costarricense de Seguro Social, San José, Costa Rica

DOI: 10.2478/jccm-2026-0020

Introduction: This study describes the epidemiological and clinical profile of ICU patients undergoing percutaneous tracheostomy in Costa Rica and identifies predictors of acute complications, addressing ongoing debates on timing, technique, and risk stratification.
Methods: We performed a prospective multicenter cohort study in eight CCSS hospitals (2019–2022), including adult ICU patients undergoing percutaneous tracheostomy. Demographic, clinical, and procedural data were collected, and multivariable logistic regression identified predictors of complications.
Results: A total of 516 patients were analyzed (mean age 53.2 ± 16.3 years; 68.2% male). The main indications were anticipated prolonged ventilation (32.4%), neurological deficits (26.7%), and ventilation >10 days (21.8%). The Ciaglia and Griggs techniques were used in 51.0% and 48.3% of cases, respectively. Capnography was applied in 74.2%, ultrasound in 17.7%, and bronchoscopy in 3.1%. First-pass success was achieved in 85.1%. Acute complications occurred in 28.3% of patients, predominantly minor bleeding (25.4%), while serious complications (airway loss, false passage, or bleeding requiring surgery) were rare (3.9%). No procedure-related deaths were observed. Independent predictors of complications included anticoagulation (OR 2.82), obesity (OR 2.10), coagulopathy (OR 2.29), prior neck surgery (OR 3.49), cervical immobilization (OR 4.68), and technical difficulty (OR 4.15 for any complication; OR 2.00 for serious complications). Airway management by physicians, compared with respiratory therapists, was also associated with higher risk (OR 1.52).
Conclusions: Percutaneous tracheostomy was feasible in multiple ICUs of the CCSS with complication rates comparable to international cohorts. Risk factors for complications included anticoagulation and prior neck surgery. Wider adoption of adjunctive monitoring tools and structured multidisciplinary training may further enhance procedural safety. These findings should be interpreted in the context of an observational design and a broad definition of complications.

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