The Transition in Intensive Care Unit Patients: A Concept Analysis

2020 ◽  
Author(s):  
Kobra Ghorbanzadeh ◽  
Abbas Ebadi ◽  
Mohammadali Hosseini ◽  
Sadat Madah ◽  
hamidreza Khankeh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Environmental Changes ◽  
Transition Process ◽  
Healthcare Setting ◽  
Concept Analysis ◽  
Care Providers ◽  
Normal Life ◽  
Definition Of

Abstract Background: Transition in the health system is associated with the movement of the patient between clinical units and between hospitals, This is a complex process with several potential challenges including medical errors, adverse events, increased costs and patient dissatisfaction. Evidence shows that there is a need for greater clarity regarding the concept of transition. Objectives: The present Study was conducted to clarify the core elements of transition in patients admitted to the ICU.Methods: Walker and Avant's eight-step model was used to guide this concept analysis to provid a comprehensive definition of transition. A Literature search was conducted on CINAHL, Scopus, Pubmed, and Google scholar using the following keywords: transition, intensive care unit, transition care, patient transfer and transition process. Thus, after an extensive review of resources published in the years 2000-2020, articles related to this concept were examined based on the inclusion criteria. Definitions, properties, applications, consequences and empirical references of the concept of transition were extracted.Results: Transition is a complex, multifaceted concept with defining attributes: Critical points and events, disturb normal life, passage of change, instability and un-anticipated changes, Multiple needs, Inadequate continuity of care, Poor coordination of care and communication among health care providers, patients and families, multiple factor, multiple professionals, Awareness, Engagement And Adaptation. The differences in the response to transition according to the patient's condition or position (beliefs, attitudes, socioeconomic status, willingness and knowledge) and environmental conditions (the status of communication and support from the community) lead to the development of confidence, adaptation, recovery from critical illness and return to normal life or disability and other complications.Conclusion: The transition is a process of progressive change and the adaptation requires training and environmental changes to improve and develop new skills for transition. Nurses play a supportive and complementary role in successful transition of patients. Therefore, studies need to focuse on the evaluation of nurses' perceptions of patient transition and the consequences and outcomes. The result of this study provide a definition of transition that is relevant and useful for clinical research and practice in healthcare setting.

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.

Visitation in the Pediatric Intensive Care Unit: Controversy and Compromise

1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
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

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.

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

2018 ◽  
Vol 38 (3) ◽  
pp. 18-26 ◽  
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.

scholarly journals Pharmacists’ Perceptions on Their Role, Activities, Facilitators, and Barriers to Practicing in a Post-Intensive Care Recovery Clinic

2019 ◽  
Vol 55 (2) ◽  
pp. 119-125
Author(s):  
Antoinette B. Coe ◽  
Rebecca E. Bookstaver ◽  
Andrew C. Fritschle ◽  
Michael T. Kenes ◽  
Pamela MacTavish ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Direct Patient Care ◽  
Care Providers ◽  
Medication Regimen ◽  
Medication Reviews ◽  
Facilitators And Barriers

Background: Complex medication regimen changes burden intensive care unit (ICU) survivors and their caregivers during the transition to home. Intensive care unit recovery clinics are a prime setting for pharmacists to address patients’ and their caregivers’ medication-related needs. The purpose of this study was to describe ICU recovery clinic pharmacists’ activities, roles, and perceived barriers and facilitators to practicing in ICU recovery clinics across different institutions. Methods: An expert panel of ICU recovery clinic pharmacists completed a 15-item survey. Survey items addressed the pharmacists’ years in practice, education and training, activities performed, their perceptions of facilitators and barriers to practicing in an ICU recovery clinic setting, and general ICU recovery clinic characteristics. Descriptive statistics were used. Results: Nine ICU recovery clinic pharmacists participated. The average number of years in practice was 16.5 years (SD = 13.5, range = 2-38). All pharmacists practiced in an interprofessional ICU recovery clinic affiliated with an academic medical center. Seven (78%) pharmacists always performed medication reconciliation and a comprehensive medication review in each patient visit. Need for medication education was the most prevalent item found in patient comprehensive medication reviews. The main facilitators for pharmacists’ successful participation in an ICU recovery clinic were incorporation into clinic workflow, support from other health care providers, and adequate space to see patients. The ICU recovery clinic pharmacists perceived the top barriers to be lack of dedicated time and inadequate billing for services. Conclusions: The ICU recovery clinic pharmacists address ICU survivors’ medication needs by providing direct patient care in the clinic. Strategies to mitigate pharmacists’ barriers to practicing in ICU recovery clinics, such as lack of dedicated time and adequate billing for pharmacist services, warrant a multifaceted solution, potentially including advocacy and policy work by national pharmacy professional organizations.

Mothers’ Stories about Their Experiences in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Family Factors ◽  
Parental Role ◽  
Parental Distress ◽  
Care Providers

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

scholarly journals Accreditation is not a One-time Process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a Tertiary Care Hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 29-41
Author(s):  
Suneeta Dubey ◽  
VK Tadia ◽  
Monalisa LNU
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Assessment ◽  
Health Care Providers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Process Quality ◽  
Care Hospital ◽  
Time Process ◽  
Care Providers

ABSTRACT Accreditation is an integral part of quality and it is not a onetime process. This study was done to know the extent to which hospitals maintain the standards after obtaining accreditation. This study tries to find out the gaps in standards during the postaccreditation period. The objective of the study was to assess the policies of the intensive care unit (ICU) with reference to standard protocols of the National Accreditation Board for Hospital and Health Care Providers (NABH) and measures taken by the management to maintain the standards. Data was collected from a 285-bedded NABH-accredited hospital that had five ICUs and four recovery rooms by means of nonparticipant observation, semistructured interviews. Data on indicators was collected by using the hospital management information system; the questionnaire on satisfaction was filled by 30 patients/relatives who were admitted in the ICU for more than a week. Quality team was interviewed to know the perception of the management toward quality and accreditation. To know the compliance of the staff to the NABH standards, a surprise check was done in three ICUs of the hospital. Data analysis showed that the organization was not able to maintain the standards, as it had done at the time of accreditation. The quality team strongly accepted that accreditation helps in maintaining and improving quality, whereas the data from ICUs showed a wide variation in compliance. Three ICUs from the same hospital were having different compliance rates for standards, which shows that staff was not aware about the standard protocol to be followed. The patient-satisfaction questionnaire also showed that the patients were not satisfied with the services given. How to cite this article Tadia VK, Monalisa, Dubey S. Accreditation is not a One-time Process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2017;5(1):29-41.

Loyalty and Hope: Keys to Parenting in the NICU

2003 ◽  
Vol 22 (4) ◽  
pp. 39-45 ◽  
Author(s):  
Margo Charchuk ◽  
Christy Simpson
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Care Providers ◽  
Medical Needs

When a newborn is admitted to a neonatal intensive care unit the parents may experience a variety of emotions, including a heightened sense of loyalty to their child. While health care providers are working to meet the medical needs of their patients, parents need to find ways to fulfill this sense of loyalty and to express it via hope. Through sharing the experience of having a child in the NICU, I examine hope and loyalty as critical features of parents’ NICU experience, explaining why these emotions need to be acknowledged and encouraged by health care professionals.

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