Needs of Patients’ Family Members in an Intensive Care Unit With Continuous Visitation

2016 ◽  
Vol 25 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Mini Jacob ◽  
Cynthia Horton ◽  
Sharon Rance-Ashley ◽  
Tera Field ◽  
Robbie Patterson ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Rank Order ◽  
Family Members ◽  
Continuous Family ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Level Of Satisfaction ◽  
National Organizations ◽  
High Level

BackgroundAlthough many critical care experts and national organizations support open visitation in intensive care units (ICUs), most ICU visiting policies do not allow unrestricted presence of patients’ family members.ObjectiveTo describe how well the needs of family members were met in an adult neuroscience ICU with a continuous visitation policy and an adjoining private suite for patients’ family members.MethodsAn exploratory, descriptive study design was used to identify the effects of continuous family visitation in the neuroscience ICU on patients’ family members and their needs and experiences during their time in the unit. A convenience sample of consenting family members completed a survey of family need items 72 hours after the patient was admitted to the unit.ResultsThe most important needs identified by the 45 family members surveyed were items relating to information about the patient, visiting the patient, being given hope, talking with a doctor each day, and being assured that the best care is being given to the patient. Least important items were related to physical comforts for the family members. The vast majority of family members rated their needs as being met for all of the items in the survey and reported a high level of satisfaction with care.ConclusionIn a neuroscience ICU with an open visitation policy and a private suite for patients’ family members, family members rated their needs as being met at a high level, unlike in prior studies in units with limitations on family visitation. The rank order of the importance of each need in the survey was similar to rankings in prior studies in a variety of critical care units.

Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic

2020 ◽  
Vol 40 (4) ◽  
pp. 25-31 ◽  
Author(s):  
Sandy L. Arneson ◽  
Sara J. Tucker ◽  
Marie Mercier ◽  
Jaspal Singh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Holistic Approach ◽  
Critical Care Units ◽  
Work From Home ◽  
New Strategy ◽  
High Level ◽  
Intensive Care Unit Nurses

Background The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. Objective To describe how the skilled tele–intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. Methods We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele–intensive care unit nurses to work from home. Results Tele–intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele–intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. Conclusion Tele–intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.

scholarly journals Interpersonal Communication among Critical Care Nurses: an Ethnographic Study

2020 ◽  
Vol 9 (1) ◽  
pp. 57-64
Author(s):  
Tayebeh Mahvar ◽  
Nooredin Mohammadi ◽  
Naima Seyedfatemi ◽  
AbouAli Vedadhir
Keyword(s):  
Critical Care ◽  
Interpersonal Communication ◽  
Critical Care Nurses ◽  
Ethnographic Study ◽  
Critical Conditions ◽  
Structured Interviews ◽  
Critical Care Units ◽  
Effective Care ◽  
High Level ◽  
Communication Culture

Introduction: Interpersonal communication in critical care units is one of the most important factors due to complicated and critical conditions of patients. Nurses’ confrontation with ethical distresses and conflict resolution techniques are often influenced by the culture governing these units. This study aimed to explore interpersonal communication culture among critical care nurses. Methods: A focused ethnographic approach was used to conduct study in Iran. The research method was based on the research evolutionary cycle model recommended by Spradley (1980). Data were collected over six months through purposeful sampling and semi structured interviews (n=18) and participation observation (n=43). The data were obtained over six months of observation and interview with participants. Data analysis was done by Spradley method and was interpreted to discover the meaning units from the obtained themes. MAXQDA10 was used to manage data. Results: Five major domains of observations and high-level consensus were extracted in this study, including grouping, work-life interaction, professionalism, organizational atmosphere and experience. Conclusion: Development of interpersonal communication culture is influenced by various factors. Besides, the working models and nurses’ use of workspace are indispensable components of effective communication at workplace. The findings of this study can be helpful in determining appropriate strategies and practices to resolve communication problems among nurses by specifying challenges, thereby leading to proper communication among nurses, promoting this communication and finally providing high quality and more effective care.

Designing and Validity Evaluation of Quality of Nursing Care Scale in Intensive Care Units

2014 ◽  
Vol 22 (3) ◽  
pp. 461-471
Author(s):  
Mashaalah Zeraati ◽  
Negin Masoudi Alavi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Content Validity ◽  
Scale Level ◽  
Validity Index ◽  
Critical Care Units ◽  
Quality Of Nursing

Background and Purpose: Quality of nursing care measurement is essential in critical care units. The aim of this study was to develop a scale to measure the quality of nursing care in intensive care units (ICUs). Methods: The 68 items of nursing care standards in critical care settings were explored in a literature review. Then, 30 experts evaluated the items’ content validity index (CVI) and content validity ratio (CVR). Items with a low CVI score (<0.78) and low CVR score (<0.33) were removed from the scale. Results: The 50 items remained in the scale. The Scale level-CVI and Scale level-CVR were 0.898 and 0.725, respectively. Conclusion: The nursing care scale in ICU (Quality of Nursing Care Scale-ICU) that was developed in this research had acceptable CVI and CVR.

Accuracy of infrared ear thermometry and other temperature methods in adults

1994 ◽  
Vol 3 (1) ◽  
pp. 40-54 ◽  
Author(s):  
RS Erickson ◽  
LT Meyer
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
High Variability ◽  
External Factors ◽  
University Teaching ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Bladder Temperature ◽  
Pulmonary Artery Catheters

OBJECTIVE: To compare the accuracy of infrared ear-based temperature measurement in relation to thermometer, ear position, and other temperature methods, with pulmonary artery temperature as the reference. METHODS: Ear-based temperature measurements were made with four infrared thermometers, three in the core mode and two in the unadjusted mode, each with tug and no-tug techniques. Pulmonary artery, bladder (n = 21), and axillary temperatures were read after each ear-based measurement and oral temperature was measured once when possible (n = 32). Subjects consisted of a convenience sample of 50 patients with pulmonary artery catheters who were in adult critical care units of a university teaching hospital. RESULTS: Ear-based measurements correlated well with pulmonary artery temperature (r = .87 to .91), although closeness of agreement differed among thermometer-mode combinations (mean offsets = -0.7 to 0.5 degree C) and had moderately high variability between subjects (SD = +/- 0.5 degree C) with all instruments. Use of an ear tug either made no difference or resulted in slightly lower readings. Bladder temperature was nearly identical to pulmonary artery temperature values (r = .99, offset = 0.0 +/- 0.2 degree C). Oral readings were slightly lower (r = .78, offset = -0.2 degree C) and axillary readings much more so (r = .80 to .82, offset = -0.7 degree C); both were highly variable (SD = +/- 0.6 degree C) and affected by external factors. CONCLUSIONS: Infrared ear thermometry is useful for clinical temperature measurement as long as moderately high variability between patients is acceptable. Readings differ among thermometers, although several instruments provide values close to pulmonary artery temperature in adults. Readings are not higher with an ear tug. Bladder temperature substitutes well for pulmonary artery temperature, whereas oral and axillary values may be influenced by external factors in the critical care setting.

scholarly journals Perception of Nurses on Needs of Family Members of Patient Admitted to Critical Care Units of Teaching Hospital, Chitwan Nepal: A Cross-Sectional Institutional Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ishwori Khatri Chhetri ◽  
Bedantakala Thulung
Keyword(s):  
Critical Care ◽  
Teaching Hospital ◽  
Family Members ◽  
College Teaching ◽  
Patient Treatment ◽  
Family Needs ◽  
Cross Sectional ◽  
Critical Care Units ◽  
Medical College ◽  
Significant Difference

Background. Critical care units’ nurses should seek to develop collaborative relationships with patients’ family members based on their needs and help them to cope with their distress. The objective of this study was to find out the perception of nurses on needs of family members of patients admitted to critical care units.Methods. A descriptive cross-sectional study was conducted in Chitwan Medical College Teaching Hospital among all 65 nurses working in critical care units. Ethical clearance was obtained from Chitwan Medical College Institutional Review Committee. Data were collected from March 27 to April 25, 2016, using Critical Care Family Needs Inventory (CCFNI). Obtained data were analyzed using descriptive and inferential statistics.Results. This study found that mean age of the nurses was 23.98 ± 4.05 years. More than half of the nurses had completed PCL in nursing (52.3%) and had 1-5 years of experience in critical care units (58.5%). Nurses ranked the needs for assurance as most important needs with mean percent (86.25%) followed by needs for information (78.58%), need for comfort (69.59%), needs for closeness (69%), and needs for support (64.13%). Out of 45 family needs, 81.5% of nurses perceived that knowing about patient treatment is very important for family members. Married nurses perceived the needs for support to be more important than unmarried nurses (p=0.04) whereas unmarried nurses perceived the needs for information to be more important than married (p=<0.01). There was significant difference on perception of nurses on needs of assurance with ethnicity (p=0.009) and critical care experience (p=0.04).

scholarly journals Family caregivers’ expectations and needs in Critical Care Units

2021 ◽  
Vol 4 (2) ◽  
pp. 87-94
Author(s):  
Asma Khalil ◽  
Raisa Begum Gul
Keyword(s):  
Critical Care ◽  
Life Experience ◽  
Tertiary Care ◽  
Family Members ◽  
Structured Interview ◽  
Critical Care Units ◽  
Content Analysis Method ◽  
The Family ◽  
Need For Support ◽  
The Cost

Introduction: Patient admission into the critical care unit is usually an unpleasant and unexpected life experience for the family members, and unusual for family members to cope with stress and anxiety during their hospital stay.  Purpose: This study aimed to explore the expectations and needs of family members of the patients in critical care units at two tertiary care hospitals in Islamabad. Methodology: An exploratory descriptive design was used to address the study questions. Using purposive sampling, 14 family members were individually interviewed through a semi- structured interview guide. A conventional content analysis method was used to analyze the data through which categories and sub-categories were identified. Findings: The data analysis revealed three roles of the family members, which included assistance in physical care, facilitator in the provision of treatment and the decision maker. The participants expressed that their needs for information and assurance were being met to some extent; however, their need for support and comfort were not. Although the physical facilities for meeting the comfort were available in private hospital, it did not match the family members’ expectations. Conclusion: This study revealed that despite some similarities in the role and needs, the expectations and satisfaction of the family members is linked to their awareness of the healthcare system as well as the cost of the obtained services. The suggestions of the family members are implementable to improve their experiences and satisfaction in critical care units, which can enable them to perform their roles better. 

scholarly journals Medicines use review service in community pharmacies in Spain: REVISA project

2019 ◽  
Author(s):  
Nuria García-Agua Soler ◽  
Eugenia Gómez-Bermúdez ◽  
Vicente J. Baixauli-Fernández ◽  
Sara Bellver-Beltrán ◽  
Javier Velasco-Martínez ◽  
...  
Keyword(s):  
Healthcare Services ◽  
Community Pharmacies ◽  
Medicine Use ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Level Of Satisfaction ◽  
Medicines Use ◽  
High Level ◽  
Mean Time ◽  
Medicines Use Review

Abstract Background: Community pharmacy services play an important role in controlling some factors related to medicine use, and pharmaceutical services integrated with primary healthcare services are critical to achieve the desired outcomes and to significantly reduce harms that can otherwise arise from multiple medicine use, such as non-adherence or medicine-related problems. The aim of the REVISA project is to carry out a study on preliminary implementation of the medicines use review (MUR) service in Spanish pharmacies through pharmacist-led initiatives to obtain a better understanding of patients’ medication adherence and medicine-related problems, together with satisfaction and acceptability of the service and whether patients might be willing to pay for it in the future. Methods: A preliminary implementation, cross-sectional multicentre study was conducted using a convenience sample of voluntary community pharmacies from all regions of Spain. Descriptive and logistic regression analyses were undertaken. Results: Sixty-four community pharmacies participated and a total of 495 patients were enrolled. A slight predominance of women (56%) was noted, with a mean age of 66.09±14.71 years and a mean consumption of 5.68±2.97 medicines. As results of MUR, a total 550 referrals were made. Non-adherence with the medication (OR=1.74; 95% CI: 1.17 to 2.58), polypharmacy (OR=1.50; 95% CI: 1.02 to 2.20) and help with medication (OR=3.03; 95% CI: 1.45 to 6.34) were associated with referrals. Patients were adherent for 68.3% of their medicines. However, at the patient level, only 31.5% were adherent. Polypharmacy patients older than 65 years increased the risk of non-adherence (OR=1.56; 95% CI: 1.06 to 2.30).The mean time employed by the pharmacists in the MUR was 52.80±31.52 minutes (MUR-related cost of €17.27). Most patients expressed a high level of satisfaction with the MUR service (98.5%) and a willingness to pay for it (84%). Conclusions: The MUR service in community pharmacies in Spain can be delivered, that it appears to be acceptable to patients and that most patients said they would be willing to pay for it. Pharmacists self-reported the length of time taken to deliver a MUR although the feasibility of incorporating into everyday practice would need to be assessed.

scholarly journals Investigation of strategic management tools and techniques

2013 ◽  
Vol 61 (4) ◽  
pp. 833-840 ◽  
Author(s):  
Anna Afonina ◽  
Vladimír Chalupský
Keyword(s):  
Strategic Management ◽  
Rank Order ◽  
Data Entry ◽  
Quantitative Approach ◽  
Management Tools ◽  
Essential Information ◽  
Level Of Satisfaction ◽  
Analyse Data ◽  
High Level ◽  
Tools And Techniques

The paper is focused on investigation of strategic managmene tools and techniques used by Czech companies. The quantitative approach was used for the analysis of strategic management tools and techniques. The aim of the quantitative approach was to collect and analyse data about the awareness, satisfaction and utilization of strategic management tools and techniques. The empirical research was conducted via a questionnaire survey of Czech companies. Empirical data were collected from 74 companies in Czech Republic. For the data entry and processing data were used the Statictical package for the Social Science (SPSS). The study presents four groups of tools and techniques based on the perceived results of manager’s utilization and satisfaction. The most of the examined tools and techniques concentrated on the two groups: (1) power tools, this group include the tools and techniques with high level of utilization and high level of satisfaction; (2) rudimentary tools, which includes the tools and techniques with low satisfaction and low utilization. The Spearman rank order correlation coefficient was used to identify the relationship between utilization of strategic management tools and techniques and managerial awareness. The results provide essential information on the application of strategic management tools and techniques, and indicate the level of managerial awareness of strategic management tools and techniques. In addition the findings indicate a positive relationship between the utilization of strategic management tools and techniques and managerial awareness.

Hyperglycemic Emergencies

1992 ◽  
Vol 3 (2) ◽  
pp. 350-360
Author(s):  
Deborah Orange Sauve ◽  
Christine Ashley Kessler
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Receptor Site ◽  
The Elderly ◽  
Positive Outcome ◽  
Fluid Replacement ◽  
Common Denominator ◽  
Critical Care Units ◽  
Beta Cell Destruction ◽  
Clinical Awareness

Hyperglycemic emergencies are the most common endocrinopathies that require intensive care. It is estimated that between 10% and 15% of patients admitted to intensive care units experience complications of acute hyperglycemia. The common denominator of hyperglycemic emergencies is diabetes mellitus, a group of diseases in which, either because of beta-cell destruction of the pancreas or insulin receptor-site defects, there is a relative or absolute deficiency of insulin that results in hyperglycemia. In response to various precipitating factors, staggering hyperglycemia may develop in the form of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNK). The existence of DKA has been known since ancient times, and critical care nurses are familiar with the diagnosis. The more lethal disorder of HHNK was “rediscovered” in the 1950s and is occurring with greater frequency as clinical awareness of the condition grows and the elderly (who are at greatest risk for the disorder) populate critical care units in increasing numbers. Prevention is instrumental in abating deadly hyperglycemic emergencies. A positive outcome can be realized but only with timely diagnosis and prompt hormonal and fluid replacement

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