Mapping the landscape of post-intensive care recovery interventions and their barriers: A nationwide cross-sectional survey

Recovery interventions initiated in the intensive care unit (ICU) or after discharge are essential for supporting ICU survivors and their families. Despite national guidelines aimed at standardizing and improving post-ICU care, implementation varies due to systemic and operational barriers. This study evaluates the organization of post-ICU care in the Netherlands, assesses whether national guideline recommendations are appropriated in practice, and explores barriers to implementation from healthcare professionals' perspectives. A nationwide cross-sectional study was conducted (November 2023- February 2024) across all Dutch hospitals with adult ICUs. A structured, telephone-administered questionnaire collected data on ICU characteristics, post-ICU care coordination, early and late recovery interventions, and implementation barriers. The data were compared with a similar 2018 study. All 72 ICUs (100 %) participated. While 97.2 % provided at least one early and one late post-ICU recovery intervention-such as ICU diaries (97.2 %), ward follow-ups (93.1 %), and aftercare consultations (93.1 %)- only 27.8 % reported appropriating the full range of the national guideline strategies. Reported barriers included limited time, staff shortages, and financial constraints. While overall post-ICU care provision remained stable compared to 2018, notable improvements were observed in protocol use, nurse involvement in ICU diaries, and family engagement. Despite the widespread post-ICU care provision, full appropriation of national guideline recommendations remains limited. Addressing practical barriers is essential for fostering consistent, high-quality post-ICU care. Targeted interventions are needed to bridge gaps and support equitable, patient-centered recovery pathways.