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 Relationships Among Palliative Care, Ethical Climate, Empowerment, and Moral Distress in Intensive Care Unit Nurses

2018 ◽  
Vol 27 (4) ◽  
pp. 295-302 ◽  
Author(s):  
Krista Wolcott Altaker ◽  
Jill Howie-Esquivel ◽  
Janine K. Cataldo
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Ethical Climate ◽  
Moral Distress ◽  
Care Delivery ◽  
National Database ◽  
Palliative Care Teams ◽  
Intensive Care Unit Nurses ◽  
Distress Scale

Background Intensive care unit nurses experience moral distress when they feel unable to deliver ethically appropriate care to patients. Moral distress is associated with nurse burnout and patient care avoidance. Objectives To evaluate relationships among moral distress, empowerment, ethical climate, and access to palliative care in the intensive care unit. Methods Intensive care unit nurses in a national database were recruited to complete an online survey based on the Moral Distress Scale–Revised, Psychological Empowerment Index, Hospital Ethical Climate Survey, and a palliative care delivery questionnaire. Descriptive, correlational, and regression analyses were performed. Results Of 288 initiated surveys, 238 were completed. Participants were nationally representative of nurses by age, years of experience, and geographical region. Most were white and female and had a bachelor’s degree. The mean moral distress score was moderately high, and correlations were found with empowerment (r = −0.145; P = .02) and ethical climate scores (r = −0.354; P < .001). Relationships between moral distress and empowerment scores and between moral distress and ethical climate scores were not affected by access to palliative care. Nurses reporting palliative care access had higher moral distress scores than those without such access. Education, ethnicity, unit size, access to full palliative care team, and ethical climate explained variance in moral distress scores. Conclusions Poor ethical climate, unintegrated palliative care teams, and nurse empowerment are associated with increased moral distress. The findings highlight the need to promote palliative care education and palliative care teams that are well integrated into intensive care units.

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

2007 ◽  
Vol 15 (4) ◽  
pp. 598-604 ◽  
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.

Family Presence in the Adult Burn Intensive Care Unit During Dressing Changes

2013 ◽  
Vol 33 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Sarah M. Bishop ◽  
Mandi D. Walker ◽  
I. Mark Spivak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Care Delivery ◽  
Infection Rates ◽  
Family Presence ◽  
Staff Members ◽  
Discharge Readiness ◽  
University Of Louisville ◽  
Centered Care ◽  
Family Centered

ObjectivesTo improve communication, discharge readiness, and satisfaction of burn patients and their families.MethodsIn March 2009, the burn intensive care unit at University of Louisville Hospital, Louisville, Kentucky, incorporated family presence during dressing changes. Adverse family events during observation, measures of patient- and family-centered care according to a standardized patient satisfaction survey, infection rates, and staff members’ response to the intervention were tracked.ResultsThrough December 2011, no adverse family events occurred, patients’ satisfaction scores increased, and infection rates did not increase. Staff members responded positively to the project.ConclusionsAllowing family presence during dressing changes provides an opportunity to educate and include patients’ family members in care delivery.

scholarly journals Intensive Care Nurses’ Perceptions of Routine Dyspnea Assessment

2020 ◽  
Vol 29 (2) ◽  
pp. 132-139
Author(s):  
Kathy M. Baker ◽  
Natalia Sullivan Vragovic ◽  
Robert B. Banzett
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Measurement Tool ◽  
Nurses Perceptions ◽  
Intensive Care Unit Nurses ◽  
The Impact ◽  
Routine Assessment ◽  
Dyspnea Assessment

Background Dyspnea (breathing discomfort) is commonly experienced by critically ill patients and at this time is not routinely assessed and documented. Intensive care unit nurses at the study institution recently instituted routine assessment and documentation of dyspnea in all patients able to report using a numeric scale ranging from 0 to 10. Objective To assess nurses’ perceptions of the utility of routine dyspnea measurement, patients’ comprehension of assessment questions, and the impact on nursing practice and to gather nurses’ suggestions for improvement. Methods Data were obtained from interviews with intensive care unit nurses in small focus groups and an anonymous online survey randomly distributed to nurses representing all intensive care units. Results Intensive care unit nurses affirmed the importance of routine dyspnea assessment and documentation. Before implementing the measurement tool, nurses often assessed for breathing discomfort in patients by using observed signs. Most nurses agreed that routine assessment can be used to predict patients’ outcomes and improve patient-centered care. Nurses found the assessment tool easy to use and reported that it did not interfere with workflow. Nurses felt that patients were able to provide meaningful ratings of dyspnea, similar to ratings of pain, and often used patients’ ratings in conjunction with observed physical signs to optimize patient care. Conclusion Our study shows that nurses understand the importance of routine dyspnea assessment and that the addition of a simple patient report scale can improve care delivery and does not add to the burden of work-flow.

Palliation of Thirst in Intensive Care Unit Patients: Translating Research Into Practice

2019 ◽  
Vol 39 (5) ◽  
pp. 21-28
Author(s):  
Ann Leemhuis ◽  
Yuriko Shichishima ◽  
Kathleen Puntillo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rating Scale ◽  
Family Members ◽  
Numeric Rating Scale ◽  
Video Training ◽  
Level Of Satisfaction ◽  
Scale Scores ◽  
Intensive Care Unit Nurses ◽  
Numeric Rating

Background Thirst is prevalent among patients in intensive care units. A research-based “thirst bundle” was shown to significantly decrease thirst in these patients. Objective To implement a research-based thirst intervention performed by intensive care unit nurses and patients’ family members. Methods Nurses and family members were taught the thirst intervention through video training and project team reinforcement. The intervention was performed by nurses for 123 patients and by family members for 13 patients. Thirst was measured with a numeric rating scale of 0 to 10, a word scale of 0 to 3, or “yes/no” answers, whichever was easiest for the patient. Inferential statistics were used to assess changes in thirst scores over time. Also assessed were nurse and family member burden levels, family level of satisfaction, and patient enjoyment. Results Thirst scores on the numeric rating scale decreased significantly: from a mean (SD) of 7.9 (2.0) before to 3.9 (2.7) after the intervention for nurses (P < .001); and from 9.2 (1.5) to 5.3 (2.6) for family members (n = 13; P = .002). Word scale scores also decreased significantly, from a median (interquartile range) of 3 (3-3) before to 2 (1-2) after the intervention for nurses (P < .001). Most patients (96%) reported enjoying the procedure. Median burden levels were less than 2 on a numeric rating scale of 0 to 10. Conclusions The palliative “thirst bundle” significantly alleviated patients’ thirst and resulted in little caregiver burden. Further efforts are warranted to incorporate this intervention into intensive care unit practice.

Sign in / Sign up

Export Citation Format

Share Document