Table 2 Ambiguity types in intensive care units leading to inconsistency in complying with guidelines
Type of ambiguityDescription
Task ambiguityPatient: Do I know which guidelines are applicable for my patients?
Status: What part of the guideline had already been performed? What part had not?
Plan: What task(s) need to be completed for this patient per guidelines?
Timing: When should this task be completed per guidelines?
Goal: What is the goal for the patient with respect to a particular guideline?
Expectation ambiguityStandards: What are the acceptable practices in this unit regarding complying with a particular guideline? What is the regular practice?
Performance: How is my performance regarding complying with guidelines? How is the performance of the unit? Will compliance be part of my performance evaluation?
Feasibility: Is it feasible to follow this guideline in addition to my other responsibilities?
Responsibility ambiguityRole: Who is responsible for completing this step of the guideline?
Accountability: Which care provider(s) are accountable for the consequences of deviations from a particular guideline?
Authority: Who has the authority to make a decision with regards to applicability of a guideline for a particular patient?
Method ambiguityProcedural: How to complete a particular step of a guideline?
Source: Where to find the necessary information on a step of a guideline?
Supplies and equipment: Where and how to find the necessary supplies and equipment needed for following a guideline?
Help: Who to contact for help with following a guideline? How to contact?
Exception ambiguityShould this patient be excluded from this guideline due to her conditions?
What are the exclusionary conditions of this guideline to avoid additional risk to the patient or an affect on the patient’s comfort?