Effects of a person‐centred care intervention in an intensive care unit: Using mixed methods to examine nurses’ perspectives

2020 ◽  
Author(s):  
Hye Jin Yoo ◽  
JaeLan Shim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mixed Methods ◽  
Care Intervention

scholarly journals Cognitive impairment in intensive care unit patients: A pilot mixed-methods feasibility study exploring incidence and experiences for recovering patients

2019 ◽  
Vol 32 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Rosalind Elliott ◽  
Elizabeth Yarad ◽  
Sarah Webb ◽  
Katherine Cheung ◽  
Frances Bass ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cognitive Impairment ◽  
Mixed Methods ◽  
Feasibility Study

scholarly journals Childrens participation in the PICU from the nurses' perspective

2018 ◽  
Vol 9 (4) ◽  
pp. 65 ◽  
Author(s):  
Elisabeth Wimo ◽  
Ann-Mari Fagerdahl ◽  
Janet Mattsson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Data Collection ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Nursing Care ◽  
Pediatric Intensive Care ◽  
Qualitative Approach ◽  
Interpretive Phenomenology ◽  
Care Intervention

Children who are critically ill are vulnerable and the nurse has a responsibility to meet the child's needs in a pediatric intensive care unit (PICU). The aim was to explore the vulnerable child's participation and how it can be understood through the nurses’ perspective in the nursing care intervention. The study design was an exploratory inductive qualitative approach. Data collection was done through observations and interviews. The data from the observations were analyzed through interpretive phenomenology. The affective elements were viewed as essential for uncover how children participate in the PICU. Three themes emerged through the analysis: Mediated participation, Bodily participation and Participation by proxy. They all highlight different aspect of the vulnerable child's way of participating in the nursing care given, through nurses’ awareness and situated salience. The concept participation should be redefined and broadened; as participation can present itself through the child’s body in diverse ways.

scholarly journals Monitoring intensive care unit performance—impact of a novel individualised performance scorecard in critical care medicine: a mixed-methods study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019165 ◽  
Author(s):  
Shannon M Fernando ◽  
David Neilipovitz ◽  
Aimee J Sarti ◽  
Erin Rosenberg ◽  
Rabia Ishaq ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Mixed Methods ◽  
Performance Metrics ◽  
Quality Standard ◽  
Care Patient ◽  
Critical Care Medicine ◽  
Resource Utilisation ◽  
The Impact

IntroductionPatients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance is required. Performance scorecards are used by institutions for the purposes of driving quality improvement. There is no widely accepted or standardised scorecard that has been used for overall CCM performance. We aim to improve quality of care, patient safety and patient/family experience in CCM practice through the utilisation of a standardised, repeatable and multidimensional performance scorecard, designed to provide a continuous review of ICU physician and nurse practice, as well as departmental metrics.Methods and analysisThis will be a mixed-methods, controlled before and after study to assess the impact of a CCM-specific quality scorecard. Scorecard metrics were developed through expert consensus and existing literature. The study will include 19 attending CCM physicians and approximately 300 CCM nurses. Patient data for scorecard compilation are collected daily from bedside flow sheets. Preintervention baseline data will be collected for 6 months for each participant. After this, each participant will receive their scorecard measures. Following a 3-month washout period, postintervention data will be collected for 6 months. The primary outcome will be change in performance metrics following the provision of scorecard feedback to subjects. A cost analysis will also be performed, with the purpose of comparing total ICU costs prior to implementation of the scorecard with total ICU costs following implementation of the scorecard. The qualitative portion will include interviews with participants following the intervention phase. Interviews will be analysed in order to identify recurrent themes and subthemes, for the purposes of driving scorecard improvement.Ethics and disseminationThis protocol has been approved by the local research ethics board. Publication of results is anticipated in 2019. If this intervention is found to improve patient- and unit-directed outcomes, with evidence of cost-effectiveness, it would support the utilisation of such a scorecard as a quality standard in CCM.

Enhancing Communication With Family Members in the Intensive Care Unit: A Mixed-Methods Study

2020 ◽  
Vol 40 (6) ◽  
pp. 23-32
Author(s):  
Karen-leigh Edward ◽  
Alessandra Galletti ◽  
Minh Huynh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mixed Methods ◽  
Care Delivery ◽  
Clinical Care ◽  
Family Members ◽  
Staff Members ◽  
Confidence Levels ◽  
Decision Making Model ◽  
Intensive Care Unit Nurses

Background Nurses in the intensive care unit are central to clinical care delivery and are often the staff members most accessible to family members for communication. Family members’ ratings of satisfaction with the intensive care unit admission are affected more by communication quality than by the level of care for the patient. Family members may feel that communication in the intensive care unit is inconsistent. Objectives To use a shared decision-making model to deliver a communication education program for intensive care unit nurses, evaluate the confidence levels of nurses who undertook the education, and examine changes in family members’ satisfaction with communication from intensive care unit nurses after the nurses received the education. Methods A mixed-methods design was used. Seventeen nurses and 81 family members participated. Results Staff members were overall very confident with communicating with family members of critically ill patients. This finding was likely linked to staff members’ experience in the position, with 88% of nurses having more than 11 years’ experience. Family members were happy with care but dissatisfied with the environment. Conclusions Environmental factors can negatively affect communication with family members in the intensive care unit.

scholarly journals Protocol for a multicentre longitudinal mixed-methods study: feeding and survivorship outcomes in previously healthy young paediatric Intensive care survivors (the PIES Study)

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041234
Author(s):  
Kathryn Morton ◽  
Anne-Sophie Emma Darlington ◽  
L V Marino
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Paediatric Intensive Care ◽  
Free Text ◽  
Healthy Children ◽  
Post Discharge ◽  
Feeding Difficulties ◽  
Caregiver Experiences

IntroductionAn admission to paediatric intensive care unit (PICU) is associated with multiple physical and environmental stressors, often involving many negative and painful oral experiences. Evidence from children with complex medical conditions suggests that feeding difficulties post-PICU stay are common, causing significant parental anxiety. Adult intensive care unit (ICU) survivor studies suggest feeding issues lasting up to 3 months post-discharge from ICU. There is, however, a paucity of evidence regarding feeding outcomes for previously healthy children following a PICU admission and whether painful oral experiences during an admission contribute to feeding difficulties post-discharge, negatively impacting on parental/caregiver anxiety.Methods and analysisThis longitudinal mixed-methods study will explore the impact of feeding difficulties, identifying any clinical risk factors during the first 6 months of PICU discharge in previously healthy young children (≤4 years). Parents/caregivers of children will be asked to complete questionnaires relating to: feeding difficulties, parental/caregiver stress, and child and parental/caregivers’ feeding behaviours at the point of PICU discharge, 1, 3 and 6 months post-discharge. Parents/caregivers will be invited to participate in qualitative semistructured interviews at 3 and 6 months post-PICU discharge exploring parental/caregiver experiences of feeding their child after PICU. Statistical analysis of the survey data will consist of descriptive and inferential statistics, plus qualitative analysis of any free text comments using thematic analysis.Ethics and disseminationThis study will provide an insight and increase our understanding of the prevalence of feeding difficulties in previously healthy children admitted to PICU and parental/caregiver experiences. Multiple methods will be used to ensure that the findings are effectively disseminated to service users, clinicians, policy and academic audiences. The study has full ethical approval from the National Health Service Research Ethics Committee (Ref: 20/YH/0160) and full governance clearance.

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