Family and health professional experience with a nurse-led family support intervention in ICU: A qualitative evaluation study

OBJECTIVES: To investigate family and health professional experience with a nurse-led family support intervention in intensive care. DESIGN: Qualitative evaluation study. SETTING: A twelve-bed surgical intensive care unit in a 900-bed University Hospital in Switzerland. MAIN OUTCOME MEASURES: Data were collected through 16 semi-structured interviews with families (n = 19 family members) and three focus group interviews with critical care staff (n = 19) and analysed using content analysis strategies. FINDINGS: Four themes related to the new family support intervention were identified. First, families and staff described it as a valuable and essential part of ICU care. Second, it facilitated staff-family interaction and communication. Third, from staff perspective, it promoted the quality of family care. Fourth, staff believed that the family support intervention enabled them to better care for families through increased capacity for developing and sustaining relationships with families. CONCLUSIONS: An advanced practice family nursing role coupled with a family support pathway is an acceptable, appreciated and beneficial model of care delivery in the inttensive care unit from the perspective of families and critical care staff. Further research is needed to investigate the intervention's effectiveness in the intensive care unit

gaps in pain agitation and delirium management in intensive care outputs from a nurse workshop

Abstract Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation. Where do the gaps exist in pain, agitation and delirium management, what are the barriers to guideline implementation and how can these problems be addressed to ensure patients receive optimised care? As an international professional consensus exercise, a panel of seven European intensive care nurses convened to discuss how to address these questions and establish how the provision of pain, agitation and delirium management can be improved in the intensive care unit

The Venetian civic and military governors in Padua during the sixteenth century : raison d'eÌ?tat, political prestige and public promotion of the arts

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Impact of a nurse-led family support intervention on family members' satisfaction with intensive care and psychological wellbeing: A mixed-methods evaluation

Background: Families of critically ill persons face uncertainty and experience distress during and after their close other's stay in an intensive care unit (ICU). Proactive nurse engagement and support is recommended to meet families' needs in the ICU, but little is known about its impact on quality of family care. We introduced a family support intervention that consisted of an interprofessional family support pathway and a new role of an advanced practice family nurse. Objectives: The aim of the study was to examine the effect of an advanced practice nurse-led family support intervention on family members' satisfaction, wellbeing, and psychological distress. Methods: We conducted a quasi-experimental before-and-after study with embedded qualitative interviews in a Swiss University Hospital from March 2018 to July 2019 using a questionnaire (Family Satisfaction in the ICU-24 Survey, Hospital Anxiety and Depression Scale, and Impact of Event Scale-Revised-6) and qualitative interviews (n = 19) after patient discharge. Results: Families in the intervention group (n = 75) showed a trend for increased overall satisfaction (difference of 5.544, 95% confidence interval [CI]: -0.11 to 11.20), a statistically significant increase in satisfaction with decision-making (7.258, 95% CI: 0.89 to 13.63), and a nonsignificant increase in satisfaction with care (4.178, 95% CI: -1.53 to 9.89). Psychological distress was higher in the intervention group, with depression reaching statistical significance (difference of 1.706, 95% CI: 0.16 to 3.25), which may be explained by longer ICU stays and higher proportion of deaths in the intervention group. Families receiving the intervention reported to be feeling cared for, well informed, and better able to cope. Data integration suggests that early onset, fit to need, and quality of intervention were the most important intervention characteristics impacting family wellbeing. Conclusions: Our study found that family members experience a nurse-led support intervention as beneficial for their wellbeing. It increased their satisfaction, but was unable to demonstrate a favourable impact on psychological distress. Keywords: Advanced practice nurse; Anxiety; Depression; Family; Intensive care; Nursing intervention; Post-traumatic stress; Postintensive care syndrome – family; Psychological distress; Satisfaction

[Including family in nursing care of patients with delirium on intensive care units]

Angehörige von Patient(inn)en auf Intensivstationen befinden sich in einer belastenden Situation – gleichzeitig sind sie wichtig für Pflegende und Patient(inn)en, etwa bei der Prävention und Behandlung eines akuten Delirs. Für die Erarbeitung eines Konzeptes zur Nutzung der Angehörigenressourcen wurde eine systematische Literaturübersicht durchgeführt zur Fragestellung: Mit welchen Maßnahmen können Angehörige von erwachsenen Intensivpflegepatient(inn)en mit Delir in ihrer unterstützenden Rolle gefördert werden? Acht qualitative und zwei quantitative Studien konnten als relevant identifiziert werden. Durch den Einbezug in die Pflege gewinnen Angehörige Sicherheit und erweitern ihr Verständnis für die Situation. Informationen und Anleitung haben höhere Priorität als emotionale Unterstützung durch Pflegende. Patient(inn)en mit Delir können mithilfe ihrer Angehörigen einfacher kommunizieren und fühlen sich sicherer. Pflegende erhalten Informationen und können die Zusammenarbeit individuell gestalten, wobei zeitliche und personelle Engpässe als problematisch beschrieben werden. Die professionelle Unterstützung von Angehörigen durch Pflegende liegt in der Befriedigung ihrer Bedürfnisse sowie in der Anleitung bei pflegerischen Maßnahmen. Pflegende benötigen ebenfalls Unterstützung in der Begleitung der Angehörigen. Strukturelle Vorgaben sowie prozess- und handlungsbezogene Anweisungen helfen den Pflegenden, die Angehörigen systematisch einzubeziehen. Dies kann unterstützend sein in der Gewährleistung der Patient(inn)ensicherheit sowie bei der Prävention und Behandlung des Delirs