Communication with patients' families in the intensive care unit: A point prevalence study

Au, Selena; Ordons, Amanda L Roze des; Ali, Asma Amir; Soo, Andrea; Stelfox, Henry T.

doi:10.1016/j.jcrc.2019.08.031

Cited by 20 publications

(22 citation statements)

References 22 publications

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“…We found numerous changes in terms of the responsibility for, as well as delivery of, family communication, which were due to restrictions to in-person family visiting and the COVID-19 surge in ICU admissions. In general, ICU nurses, who normally provide the bulk of informal updates to the family ( 19 ), communicated less frequently, and senior ICU physicians communicated updates more frequently. A common communication strategy was the creation of a family communication or liaison team, frequently comprising healthcare professionals who did not routinely work in the ICU, were currently unable to work in the ICU (i.e., pregnant nurses or physicians), or were freshly graduated healthcare professionals ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Communication and Virtual Visiting for Families of Patients in Intensive Care during the COVID-19 Pandemic: A UK National Survey

et al. 2021

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Rationale: Restriction or prohibition of family visiting to intensive care units (ICU) during the COVID-19 pandemic poses substantial barriers to communication, and family-and patientcentred care. Objectives: Our objective was to understand how communication between families, patients and the ICU team was enabled during the pandemic. Secondary objectives were to understand strategies used to facilitate virtual visiting and associated benefits and barriers. Methods: Multi-centre, cross-sectional, self-administered electronic survey sent (June 2020) to all 217 UK hospitals with at least one ICU. Results: Survey response rate was 54%; 117/217 hospitals (182 ICUs). All hospitals imposed visiting restrictions with visits not permitted under any circumstance in 16% of hospitals (28 ICUs); 63% (112 ICUs) permitted family presence at end of life. Responsibility for communicating with families shifted with decreased bedside nurse involvement. A dedicated ICU family liaison team was established in 50% (106 ICUs) of hospitals. All but three hospitals instituted virtual visiting, although there was substantial heterogeneity in the videoconferencing platform used. Unconscious or sedated ICU patients were deemed ineligible for virtual visits in 23% of ICUs. Patients at end of life were deemed ineligible for virtual visits in 7% of ICUs. Commonly reported benefits of virtual visiting were reducing patient psychological distress (78%), improving staff morale (68%) and reorientation of delirious patients (47%). Common barriers to virtual visiting related to insufficient staff time, rapid implementation of videoconferencing technology, and challenges associated with family member ability to use videoconferencing technology or have access to a device.

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Section: Discussionmentioning

confidence: 99%

Communication and Virtual Visiting for Families of Patients in Intensive Care during the COVID-19 Pandemic: A UK National Survey

et al. 2021

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“…Previous research has shown that, when family members are present in the ICU, nurses are responsible for most of the family communication ( Au et al, 2019 ). Studies have also shown that family presence in the ICU can negatively impact nurses’ workflow and environment due to perceived loss of control, interruptions in care, and increased workload ( Berti et al, 2007 , Monroe and Wofford, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

Wendlandt

Kime

Carson

2022

Intensive and Critical Care Nursing

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Purpose To obtain information on how family visitor restriction during the COVID-19 pandemic has impacted the workplace experience of physicians and nurses in the medical intensive care unit, and to assess differences by profession. Materials and methods We developed a survey containing closed- and open-ended questions, applying both quantitative and qualitative analyses to our results. Results Of the 74 respondents, 29 (38%) were nurses and 45 (62%) were physicians. Nurses reported positive changes to daily workflow and the ability to provide medical care, while physicians reported negative changes in these areas. Both groups reported decreased comprehension and increased distress among families, and decreased ability to provide end-of-life care. For the qualitative analysis, eight themes were identified: the patient’s room as space, creation of a new space through virtual communication, time, increased complexity of care, challenges around the use of technology, adjustments to team roles and responsibilities, desire for families to return, and internal tension. Conclusion Intensive care physicians and nurses reported both positive and negative effects of family visitor restriction during the COVID-19 pandemic, with significant differences based on profession. Both groups expressed concern for an overall negative impact of visitor restriction on healthcare workers, patients, and their families.

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“…Professional organizations have advocated for family member participation during ICU bedside rounds for nearly 20 years 1,11‐13 . Recent North American data indicates increases in family presence with the adoption of open visitation policies, however this speaks little to the nature of family participation 14‐16 . By partnering with both family members and providers, we have developed an evidence‐informed approach to patient and family centered rounds that highlights the importance of six key elements foundational to patient and family centered rounds: Invitation, Orientation, Active Engagement, Summary, Opportunity for Questions, and Communication Follow‐Up, and we describe strategies to optimize these elements and interactions so that communication is more meaningful.…”

Section: Discussionmentioning

confidence: 99%

Best practices toolkit for family participation in ICU rounds

Ordons

Blades

et al. 2020

Evaluation Clinical Practice

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Rationale, Aims and Objectives Guidelines recommend inviting family members of intensive care unit (ICU) patients to rounds. We aimed to create a toolkit to support family participation in ICU bedside rounds, based upon evidence from research and in collaboration with ICU family member representatives and healthcare providers. Methods Ethnographic observations of rounds and interviews and focus groups with family members and ICU healthcare providers were analyzed for key themes, barriers and facilitators of participation, and suggestions. A full day workshop with family representatives and providers (physicians, nurses, social workers, and unit managers) from a diverse range of adult ICUs in Western Canada, including several community ICUs and a majority of large, urban ICUs enabled the collaborative development of key toolkit elements. Results We have developed an evidence‐informed approach to patient‐and‐family‐centered rounds that highlights the importance of six key elements foundational to patient and family centered rounds: Invitation, Orientation, Engagement, Summary, Questions, and Communication Follow‐Up. We describe strategies, techniques, and templates to optimize these elements and interactions so that communication is more meaningful, and to facilitate the ability of family members to adopt a meaningful role as contributing members of the care team. Conclusion There is consensus on general strategies for facilitating family participation in rounds and meaningful communication between family and the healthcare team during rounds as an important element of the continuum of communication in the ICU. The incorporation of these elements should be standardized, though tailored to user needs.

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Communication with patients' families in the intensive care unit: A point prevalence study

Cited by 20 publications

References 22 publications

Communication and Virtual Visiting for Families of Patients in Intensive Care during the COVID-19 Pandemic: A UK National Survey

Communication and Virtual Visiting for Families of Patients in Intensive Care during the COVID-19 Pandemic: A UK National Survey

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

Best practices toolkit for family participation in ICU rounds

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