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

Background: 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. Aim: 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. Methods: 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. Results: 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. Conclusion: 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.