Application of the READY framework supports effective communication between health care providers and family members in intensive care

BACKGROUND Delirium occurs in up to 80% of patients admitted to an intensive care unit. Nonpharmacologic delirium-prevention strategies, which are commonly used by the bedside nurse, have reduced the incidence and duration of delirium in patients in the intensive care unit. With increasing demands on the nurse, strategies such as including the patient’s family in delirium prevention activities should be investigated. OBJECTIVE To determine opinions and willingness of health care providers to involve patients’ families in nonpharmacologic delirium-prevention activities in the intensive care unit, and of patients’ families to be involved. METHODS Two surveys, one for intensive care unit nurses and physicians and one for patients’ families, were developed and administered. The provider survey focused on current delirium-prevention practices and opinions about family involvement. The family survey concentrated on barriers and willingness to participate in prevention activities. RESULTS Sixty nurses and 58 physicians completed the survey. Most physicians (93%) and all nurses believed families could assist with delirium prevention. Only 50% reported speaking with family members about delirium and delirium prevention. The family survey was completed by 60 family members; 38% reported a provider spoke with them about delirium. Family members reported high levels of comfort in participating in delirium-prevention activities. CONCLUSIONS Health care providers and family members are supportive of the latter performing delirium-prevention activities. Family of patients in the intensive care unit may work collaboratively with nurses to reduce the incidence and duration of delirium in these patients.

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Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

Journal of Precision Respiratory Medicine ◽

10.2500/jprm.2019.190004 ◽

2019 ◽

Vol 2 (1) ◽

pp. 53-56

Author(s):

Gustavo Ferrer ◽

Chi Chan Lee ◽

Monica Egozcue ◽

Hector Vazquez ◽

Melissa Elizee ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Health Care Providers ◽

Family Members ◽

Expected Improvement ◽

Transition Of Care ◽

Care Providers ◽

Icu Discharge ◽

Family Perceptions

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.

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Family Participation during Intensive Care Unit Rounds: Goals and Expectations of Parents and Health Care Providers in a Tertiary Pediatric Intensive Care Unit

The Journal of Pediatrics ◽

10.1016/j.jpeds.2014.08.001 ◽

2014 ◽

Vol 165 (6) ◽

pp. 1245-1251.e1 ◽

Cited By ~ 19

Author(s):

Carolyn A. Stickney ◽

Sonja I. Ziniel ◽

Molly S. Brett ◽

Robert D. Truog

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Health Care Providers ◽

Pediatric Intensive Care ◽

Family Participation ◽

Care Providers

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Visitation in the Pediatric Intensive Care Unit: Controversy and Compromise

AACN Advanced Critical Care ◽

10.4037/15597768-1994-3008 ◽

1994 ◽

Vol 5 (3) ◽

pp. 289-295 ◽

Cited By ~ 6

Author(s):

Nancy E. Page ◽

Nancy M. Boeing

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Health Care Providers ◽

Pediatric Intensive Care ◽

Care Providers ◽

The Family ◽

Centered Care ◽

Family Centered

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission

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The Effect of Facilitated Peer Support Sessions on Burnout and Grief Management among Health Care Providers in Pediatric Intensive Care Units: A Pilot Study

Journal of Palliative Medicine ◽

10.1089/jpm.2012.0231 ◽

2012 ◽

Vol 15 (11) ◽

pp. 1178-1180 ◽

Cited By ~ 14

Author(s):

Samantha Eagle ◽

Amy Creel ◽

Anne Alexandrov

Keyword(s):

Health Care ◽

Intensive Care ◽

Pilot Study ◽

Intensive Care Units ◽

Peer Support ◽

Health Care Providers ◽

Pediatric Intensive Care ◽

Care Providers ◽

Pediatric Intensive Care Units

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Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

Critical Care Nurse ◽

10.4037/ccn2018128 ◽

2018 ◽

Vol 38 (3) ◽

pp. 18-26 ◽

Cited By ~ 7

Author(s):

Shawn E. Cody ◽

Susan Sullivan-Bolyai ◽

Patricia Reid-Ponte

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Health Care Providers ◽

Family Members ◽

Management Style ◽

Family Management ◽

Care Providers ◽

Bedside Rounds ◽

The Family ◽

The Future

Background The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. Objectives To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. Methods A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. Results Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. Conclusion What health care providers say to patients’ families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information.

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Two Alternatives to Intensive Care

Ethics & Medics ◽

10.5840/em20174212 ◽

2017 ◽

Vol 42 (1) ◽

pp. 3-4

Author(s):

Alex Fleming ◽

Keyword(s):

Health Care ◽

Intensive Care ◽

Health Care Providers ◽

Hospice Care ◽

Treatment Options ◽

Care Providers ◽

Health Care Decisions ◽

Care Facilities ◽

The Many

The overall quality of life in palliative and hospice care facilities differs greatly from that in intensive care units. For example, the use of mechanical ventilation and powerful anesthetics and sedatives in the ICU can often leave otherwise informed patients incapacitated and unable to make their own health care decisions. Thus, discussions between patients and families about treatment options can be difficult, and families and surrogates are often left to do this on their own Treatments performed in the ICU are likely to be disproportionate to their needs, adding to suffering and distrust on the part of family members. To avoid this, it is important for health care providers to assess patients early and often and to discuss the proportionality of different treatments with their families and surrogates. Additionally, providers should encourage palliative and hospice care as alternatives to the many costly and likely disproportionate interventions taken in the ICU.

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