Nurse’s Perception of Family Presence during Dressing Change in the Adult: a Study in Burn Intensive Care Unit

Background and Objectives: Burn injuries can be devastating to both the patients affected and the patients’ families who support the injured person. In an effort to shield patients’ family members from and anxiety-provoking experience and protect the patients from potential infections, burn units have historically restricted visitation during dressing change but evidence indicates that these restrictions contribute to patients’ and family’s dissatisfaction and to their knowledge deficit when it comes time to care for burn patients at home. Thus this study assess the nurse’s perception of family presence during dressing change in the adult burn intensive care unit of selected tertiary care hospital in India. Material and Methods: A Non- Experimental Descriptive Survey Design with evaluative research approach was used to evaluate the nurse’s perception of Family Presence during dressing change in the Adult Burn Intensive Care Unit of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, India. A total of 30 nurses working in Adult Burn Intensive Care Unit (BICU) were selected by using the non-probability convenience method of sampling technique. A 5 points Likert scale was used for data collection. Results: The study findings showed that, Majority 22 (73.3%) of the nurses had performed dressing more than 11 times but 26 (86.7%) of the nurses had never experienced family member in dressing room during dressing and 28 (93.37%) of the nurses had never initiate family member during dressing change as well as majority 21 (70%) of the nurses had never experience of family request to be on dressing room during dressing change. Majority 12 (40%) of the nurses were disagree on family presence during dressing change, 10 (33.3%) of the nurses were had neutral perception where as minority nurses 8 (26.7) had agree regarding family presence during dressing change. Conclusion: The study revealed that majority of the nurses does not agree to have family member to be in room during dressing change even though presence of family members during dressing change will have a positive effect on patient, family, nurse, satisfaction with hospital care.

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Relatives' experience of intensive care: the other side of hospitalization

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692007000400012 ◽

2007 ◽

Vol 15 (4) ◽

pp. 598-604 ◽

Cited By ~ 11

Author(s):

Urizzi Fabiane ◽

Adriana Katia Corrêa

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Family Member ◽

Care Delivery ◽

Family Members ◽

Family Care ◽

The Other ◽

Daily Routine ◽

Reference Framework ◽

Critical Patients

This study aims at understanding the experience concerning family members of patients in the Intensive Care Unit (ICU), with the purpose of contributing to care humanization in this context. Considering the nature of the research object, this research was carried out to understand the phenomenon Being a family that experiences the hospitalization of a family member in ICU. Phenomenology was used as a methodological reference framework. Seventeen family members of adult patients in the Intensive Care Unit (ICU) at the Santa Casa in Londrina were interviewed from September to December 2004. Through analysis of these interviews, some theme categories emerged: difficult, painful, speechless experience; experiencing and recognizing somebody's life: approaching the patient's suffering; break-up of the family's daily routine; fear of having a family member die; ICU: a fearsome scene, but necessary; concern with family care. Some issues related to the family's attendance in the ICU were discussed, contributing to the establishment of humanized care delivery to critical patients and their families' uniqueness.

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Perceptions of Families of Intensive Care Unit Patients Regarding Involvement in Delirium-Prevention Activities: A Qualitative Study

Critical Care Nurse ◽

10.4037/ccn2017485 ◽

2017 ◽

Vol 37 (6) ◽

pp. e1-e9 ◽

Cited By ~ 8

Author(s):

Pamela L. Smithburger ◽

Amanda S. Korenoski ◽

Sheila A. Alexander ◽

Sandra L. Kane-Gill

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Treatment Options ◽

Family Members ◽

Prevention Strategies ◽

Family Presence ◽

Purposeful Sampling ◽

Study Team ◽

Delirium Prevention ◽

Prevention Activities

BACKGROUND Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient’s family are needed. OBJECTIVE To gain insight into opinions of patients’ families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients’ families in such activities. METHODS Purposeful sampling was used. Patients’ families were contacted to be interviewed about their opinions and attitudes on participation in nonpharmacologic delirium prevention activities while visiting the intensive care unit. An interview guide was created and used to facilitate discussion. Interviews were conducted, transcribed verbatim, and coded by 2 independent coders. Themes were identified, defined, and compared between independent coders; disagreements were resolved by the study team. RESULTS After 10 interviews were conducted, thematic saturation occurred. Three major themes emerged: (1) consistent family presence and participation in care, (2) improving ease of interactions between family and patient, and (3) delirium education for families. CONCLUSION Family members want to be involved with care and delirium prevention; however, many times they do not know what to do without the direction of a health care provider. Family members would benefit from open dialogue with the bedside nurse to increase family comfort and involvement in care.

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Faculty Opinions recommendation of Important questions asked by family members of intensive care unit patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11386956.12401054 ◽

2011 ◽

Author(s):

Rik Gerritsen

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Family Members

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Contamination of Healthcare Worker Personal Protective Equipment with MRSA Outside the Intensive Care Unit Setting

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.505 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s27-s28

Author(s):

Gita Nadimpalli ◽

Lisa Pineles ◽

Karly Lebherz ◽

J. Kristie Johnson ◽

David Calfee ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Patient Care ◽

Direct Patient Care ◽

Care Group ◽

Surveillance Culture ◽

Care Hospital ◽

Contact Precautions ◽

Patient Interactions ◽

The Right

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None

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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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Outpatient Follow-up Care After Hospital Discharge of Children With Complex Chronic Conditions at a Rural Tertiary Care Hospital

Clinical Pediatrics ◽

10.1177/00099228211047242 ◽

2021 ◽

pp. 000992282110472

Author(s):

Andrew Brown ◽

Mary Quaile ◽

Hannah Morris ◽

Dmitry Tumin ◽

Clayten L. Parker ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hospital Discharge ◽

Care Coordination ◽

Chronic Conditions ◽

Tertiary Care ◽

Care Hospital ◽

Icu Admission ◽

Complex Chronic Conditions

Objective To determine factors associated with completion of recommended outpatient follow-up visits in children with complex chronic conditions (CCCs) following hospital discharge. Methods We retrospectively identified children aged 1 to 17 years diagnosed with a CCC who were discharged from our rural tertiary care children’s hospital between 2017 and 2018 with a diagnosis meeting published CCC criteria. Patients discharged from the neonatal intensive care unit and patients enrolled in a care coordination program for technology-dependent children were excluded. Results Of 113 eligible patients, 77 (68%) had outpatient follow-up consistent with discharge instructions. Intensive care unit (ICU) admission ( P = .020) and prolonged length of stay ( P = .004) were associated with decreased likelihood of completing recommended follow-up. Conclusions Among children with CCCs who were not already enrolled in a care coordination program, ICU admission was associated with increased risk of not completing recommended outpatient follow-up. This population could be targeted for expanded care coordination efforts.

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Quality improvement of delirium status communication and documentation for intensive care unit patients during daily multidisciplinary rounds

BMJ Open Quality ◽

10.1136/bmjoq-2017-000239 ◽

2018 ◽

Vol 7 (2) ◽

pp. e000239 ◽

Cited By ~ 2

Author(s):

Krishna Aparanji ◽

Shreedhar Kulkarni ◽

Megan Metzke ◽

Yvonne Schmudde ◽

Peter White ◽

...

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Tertiary Care ◽

Care Hospital ◽

Icu Patients ◽

Quality Metric ◽

Risk Of Mortality ◽

Simulation Based ◽

Multidisciplinary Rounds

Delirium is a key quality metric identified by The Society of Critical Care Medicine for intensive care unit (ICU) patients. If not recognised early, delirium can lead to increased length of stay, hospital and societal costs, ventilator days and risk of mortality. Clinical practice guidelines recommend ICU patients be assessed for delirium at least once per shift. An initial audit at our urban tertiary care hospital in Illinois, USA determined that delirium assessments were only being performed 31% of the time. Nurses completed simulation based education and were trained using delirium screening videos. After the educational sessions, delirium documentation increased from 40% (12/30) to 69% (41/59) (two-proportion test, p<0.01) for dayshift nurses and from 27% (8/30) to 61% (36/59) (two-proportion test, p<0.01) during the nightshift. To further increase the frequency of delirium assessments, the delirium screening tool was standardised and a critical care progress note was implemented that included a section on delirium status, management strategy and discussion on rounds. After the documentation changes were implemented, delirium screening during dayshift increased to 93% (75/81) (two-proportion test, p<0.01). Prior to this project, physicians were not required to document delirium screening. After the standardised critical care note was implemented, documentation by physicians was 95% (106/111). Standardising delirium documentation, communication of delirium status on rounds, in addition to education, improved delirium screening compliance for ICU patients.

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