Table 1. Key Findings and Interventions in ICU Management for Critically Ill Patients

Health Disparities and Barriers to Health Care Access

Health disparities represent preventable differences in the burden of disease, injury, violence, or opportunities for optimal health among socially disadvantaged groups (CDC, 2017). Over one-third of the U.S. population belongs to a racial or ethnic minority group (U.S. Census Bureau, 2011). These disparities have resulted in disproportionate rates of disease, disability, and death within these communities. The COVID-19 pandemic underscored these inequalities, revealing a heightened disease impact on socially and economically disadvantaged populations.

Barriers to accessing quality health care are multifaceted and often associated with social determinants of health, such as income, education, gender, race, and geography. Lower-income individuals have limited access to health insurance, and lower educational levels are linked to reduced access to jobs offering health benefits. Gender disparities also exist, with males more likely to be treated for cardiac conditions than females, regardless of risk factors. Minority children, such as Black and Latino children, face higher hospitalization rates due to asthma complications than their white counterparts (Institute for Healthcare Improvement, n.d.). Geographic location adds further complexity, as rural residents often face barriers in obtaining timely medical care.

Health Equity, Social Justice, and Ethical Considerations in Complex Health Needs

Health equity, a cornerstone of social justice, strives to provide equal access to quality health care across all socioeconomic classes. Socioeconomic status often determines access to health care providers and facilities, leaving disadvantaged populations vulnerable to preventable health complications. For individuals with complex conditions, such as diabetes or cardiovascular disease, lack of preventive care results in frequent emergencies and critical care needs. Nurses often witness these health disparities and must advocate for equitable health care by delivering respectful, individualized care for each client, especially those with complex health conditions.

For clients with complex needs, ethical considerations around autonomy and self-determination are vital. Advance directives and do-not-resuscitate (DNR) orders safeguard clients’ rights, even when they cannot communicate their preferences. Health care providers play a central role in discussing these directives with clients and families, ensuring that treatment aligns with the clients’ values. If a client requests non-resuscitation, the health care provider documents DNR or allow-natural-death (AND) orders, specifying the level of care to be provided.

Role and Responsibilities of the Rapid Response Team

The rapid response team (RRT) plays an essential role in identifying and intervening when a client’s condition worsens in non-critical settings, aiming to reduce incidents of in-hospital cardiac arrest (IHCA) (Dukes et al., 2019). Bedside nurses are responsible for identifying early signs of deterioration and activating the RRT to address the client’s needs promptly. Symptoms such as altered vital signs, oxygen levels, and mental status may signal a need for urgent intervention. The RRT follows established protocols, including diagnostic tests, airway management, and medication administration, ensuring the client receives the necessary level of care. Ongoing evaluation and quality improvement are critical to the team’s success, with debriefing sessions designed to enhance learning and support for staff (Jackson, 2017).