Improving the Quality of Handoffs in Patient Care Between Critical Care Providers in the Intensive Care Unit

2016 ◽  
Vol 32 (4) ◽  
pp. 376-383 ◽  
Author(s):  
Sumedh S. Hoskote ◽  
Carlos J. Racedo Africano ◽  
Andrea B. Braun ◽  
John C. O’Horo ◽  
Ronaldo A. Sevilla Berrios ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Care ◽  
Care Providers

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

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.

Transition from an Open Bay to a Private Room Neonatal Intensive Care Unit Design — A Human Factors Evaluation

2005 ◽  
Vol 49 (11) ◽  
pp. 974-978 ◽  
Author(s):  
Thomas J. Smith ◽  
Sandra Clayton ◽  
Kathleen Schoenbeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Human Factors ◽  
Neonatal Intensive Care Unit ◽  
Patient Care ◽  
Neonatal Intensive Care ◽  
Patient Care Team ◽  
Care Staff ◽  
Care Technology

This report summarizes findings from a human factors evaluation of a change in the design of a neonatal intensive care unit (NICU) from an open bay (OBNICU) to a private room (PRNICU) patient care environment. The objective was to compare and contrast effects of this design change on the perceptions and performance of NICU patient care staff. Results indicate that, relative to work on the OBNICU, staff perceived that work on the PRNICU resulted in notable improvements in the quality of physical environmental conditions, their jobs, patient care and patient safety, interaction with parents of NICU patients, interaction with patient care technology and their life off-the-job. In contrast, staff perceived that the quality of interaction among different members of the NICU patient care team worsened substantially after the move to the PRNICU. The latter finding prompted the recommendation that a virtual open bay environment be implemented in the PRNICU.

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

Cardiothoracic Surgery and Postoperative Intensive Care

2019 ◽  
pp. 417-423
Author(s):  
Juan G. Ripoll Sanz ◽  
Robert A. Ratzlaff
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Cardiothoracic Surgery ◽  
Open Heart ◽  
Postoperative Intensive Care ◽  
Main Factor

Cardiothoracic surgical (CTS) critical care responsibilities have progressively shifted away from surgeons and toward intensivists in the past several decades. CTS patients present unique challenges, and optimal patient care in the intensive care unit is a main factor for the prevention of deaths after any type of open heart surgery.

Barriers to Addressing the Spiritual and Religious Needs of Patients and Families in the Intensive Care Unit: A Qualitative Study of Critical Care Physicians

2020 ◽  
pp. 104990912097090
Author(s):  
Christian K. Alch ◽  
Christina L. Wright ◽  
Kristin M. Collier ◽  
Philip J. Choi
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Spiritual Care ◽  
Spiritual Needs ◽  
Care Providers ◽  
Structured Interviews ◽  
Care Services ◽  
Qualitative Research Design ◽  
Data Saturation

Objectives: Though critical care physicians feel responsible to address spiritual and religious needs with patients and families, and feel comfortable in doing so, they rarely address these needs in practice. We seek to explore this discrepancy through a qualitative interview process among physicians in the intensive care unit (ICU). Methods: A qualitative research design was constructed using semi-structured interviews among 11 volunteer critical care physicians at a single institution in the Midwest. The physicians discussed barriers to addressing spiritual and religious needs in the ICU. A code book of themes was created and developed through a regular and iterative process involving 4 investigators. Data saturation was reached as no new themes emerged. Results: Physicians reported feeling uncomfortable in addressing the spiritual needs of patients with different religious views. Physicians reported time limitations, and prioritized biomedical needs over spiritual needs. Many physicians delegate these conversations to more experienced spiritual care providers. Physicians cited uncertainty into how to access spiritual care services when they were desired. Additionally, physicians reported a lack of reminders to meet these needs, mentioning frequently the ICU bundle as one example. Conclusions: Barriers were identified among critical care physicians as to why spiritual and religious needs are rarely addressed. This may help inform institutions on how to better meet these needs in practice.

Communication in the Intensive Care Unit About the End of Life

2007 ◽  
Vol 18 (4) ◽  
pp. 406-414
Author(s):  
Patsy D. Treece
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Positive Impact ◽  
Perceived Quality ◽  
Clinician Communication ◽  
End Of Life Communication

Communicating well in the intensive care unit is essential to providing quality critical care for the families of patients who are expected to die. There are many examples in the literature of how clinicians fall short of meeting these needs of families. There is also a developing body of literature describing approaches and tools that may have a positive impact on the perceived quality of end-of-life communication. The quality of clinician communication can be improved just as other skills that are important in the intensive care unit.

Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

2010 ◽  
Vol 19 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Mohamad F. El-Khatib ◽  
Salah Zeineldine ◽  
Chakib Ayoub ◽  
Ahmad Husari ◽  
Pierre K. Bou-Khalil
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Providers ◽  
Care Experience ◽  
Respiratory Therapists ◽  
Evidence Based Guidelines

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended.Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia.Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia.Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience.Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia.

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