Research results analyzing patient-provider dialogue of driving status and driving safety assessments after critical illness.

1. Driving Decisions
after Critical Illness
Patient-Provider Perspectives
Danesh V, McDonald, AD, McPeake, J,
Eaton, T, Su, H, Potter, K…Boehm, LM.
Driving decisions after critical illness:
Qualitative analysis of patient-provider
reviews during ICU recovery clinic
assessments. International Journal of
Nursing Studies. 2023; 146:1-7.

2. Background
u Driving ability is regularly assessed when cognitive
dysfunction is known or suspected.
u After critical illness, patients can experience new onset
cognitive decline that often goes unrecognized and
undiagnosed.
u Patient-provider dialogue provides contextual examples
of how driving is an activity of daily living relevant to life
after critical illness.
Pandharipande 2013 NEJM
Potter, Danesh, McDonald,…Girard 2023 JAMA IM

3. Purpose
u To report patient-provider dialogue of driving status and
driving safety assessments after critical illness
Danesh, McDonald…Boehm 2023 IJNS

4. Methods
Qualitative secondary analysis drawn from a two-arm randomized
controlled pilot trial evaluating the feasibility and acceptability of
telehealth delivery of Intensive Care Unit Recovery Clinic assessments
(NCT03926533). IRB #190790.
Multidisciplinary providers assessed physical, psychological, and
cognitive recovery at 3- and 12-weeks after hospital discharge via one-
hour telehealth ICU Recovery Clinic visits.
Thematic content analysis was used to classify and describe driving
status, driving practices and driving safety discussion after critical illness.
Danesh, McDonald…Boehm 2023 IJNS

5. Results
u 17 ICU survivors participated in telehealth ICU
Recovery Clinic assessments with clinician-
initiated discussion related to driving status
u Themes included current driving status,
discussion of driving safety and patient-
initiated driving modifications
u Intra-visit dialogue illustrates self-regulated
decisions to delay return to driving, care
partner concerns about ICU survivor driving
safety, and contraindications to driving.
u Most participants reported changes in driving
practices after critical illness.
Danesh, McDonald…Boehm 2023 IJNS

6. Danesh, McDonald…Boehm 2023 IJNS

7. Danesh, McDonald…Boehm 2023 IJNS

8. Danesh, McDonald…Boehm 2023 IJNS

9. Summary
u Driving status varied with participants reporting independent decisions
to resume driving, delay driving, and cease driving after critical illness.
u When clinicians initiate questions about driving status after critical
illness, patients report self-assessments of fitness to drive, including self-
restricted driving practices and concerns about driving safety.
u Assessments of ICU-acquired cognitive changes are central to
informed driving safety evaluations and future intervention
development for ICU survivors to accommodate and/or compensate
for the special needs of drivers recovering from critical illness
Danesh V, McDonald, AD, McPeake, J,
Eaton, T, Su, H, Potter, K…Boehm, LM.
Driving decisions after critical illness:
Qualitative analysis of patient-provider
reviews during ICU recovery clinic
assessments. International Journal of
Nursing Studies. 2023; 146:1-7.

10. References
u Danesh, V, McDonald, AD, McPeake, J, Eaton, TL, Potter, K, Su, H, Jackson, JC,
& Boehm, LM. (2023). Driving decisions after critical illness: Qualitative analysis
of patient-provider reviews during ICU recovery clinic
assessments. International journal of nursing studies, 146, 104560.
https://doi.org/10.1016/j.ijnurstu.2023.104560
u Pandharipande, PP, Girard, TD…Ely, E.W. (2013). Long-term cognitive
impairment after critical illness. The New England journal of medicine, 369(14),
1306–1316. https://doi.org/10.1056/NEJMoa1301372
u Potter, KM, Danesh, V, Butcher, BW, Eaton, TL, McDonald, AD, & Girard, TD.
(2023). Return to Driving After Critical Illness. JAMA Internal Medicine, 183(5),
493–495. https://doi.org/10.1001/jamainternmed.2022.7096