Critical illness trajectory for patients, families and nurses – a literature review

Page, Pamela

doi:10.1111/nicc.12199

Cited by 15 publications

(12 citation statements)

References 89 publications

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“…Our data suggest that delaying the transition from EN to PO only until a patient can demonstrate the ability to consume adequate nutrition orally may effectively enhance nutrition intake in this population. Successful LMV and transition from the ICU to ward marks a significant point in the trajectory of critical illness 28 and the beginning of the journey to recovery. Although no formal guidelines for transitioning patients from EN to an oral diet exist specifically for the recovering critically ill, Massanet et al 29 propose permanent discontinuation of EN only when a patient has demonstrated the ability to consume >75% of daily caloric needs.…”

Section: Discussionmentioning

confidence: 99%

Adequacy of Protein and Energy Intake in Critically Ill Adults Following Liberation From Mechanical Ventilation Is Dependent on Route of Nutrition Delivery

et al. 2020

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Background Studies examining nutrition intake of critically ill patients following liberation from mechanical ventilation (LMV) are scarce. The objectives of this prospective, observational feasibility study were to quantify and assess protein and energy intake in hospitalized, critically ill patients following LMV, to determine barriers to optimal intake, and to report on the feasibility of recruiting and retaining patients into this study. Methods Adult patients requiring MV for >72 hours in a medical/surgical intensive care unit (ICU) were recruited. Protein and energy intakes were quantified up to 14 days following LMV. Patients also identified barriers to eating. Results Nineteen patients (mean age, 60 years [SD, 12 years]) were studied over 125 days. Over all study days, the median amounts of protein and energy consumed in comparison with amounts prescribed by dietitians were 46% (interquartile range [IQR], 26–100) and 71% (IQR, 38–100), respectively. When stratified by route of nutrition delivery, on days (n = 54) when patients consumed an oral diet as the sole nutrition source, median amounts of protein and energy consumed in comparison with those prescribed were only 27% (IQR, 15–41) and 47% (IQR, 29–66), respectively. The most frequently reported barriers to eating were poor appetite, early satiety, and taste changes. Conclusions Protein and calorie intake is below prescribed amounts for patients whose enteral nutrition is discontinued and an oral diet prescribed as sole nutrition source following LMV. Acceptable strategies to enhance nutrition intake in post‐ICU patients during the recovery stages of critical illness are needed.

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Section: Discussionmentioning

confidence: 99%

Adequacy of Protein and Energy Intake in Critically Ill Adults Following Liberation From Mechanical Ventilation Is Dependent on Route of Nutrition Delivery

et al. 2020

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“…The environment in which men live may not be conducive to long‐term discharge care. Prior research has shown that survivors of critical illnesses need to experience dynamic interplay when endeavoring to readjust to life after critical care, and that family members could be good interpersonal and societal stimulators (Page, 2016).…”

Section: Discussionmentioning

confidence: 99%

Gender Differences Regarding the Impact of Change in Cognitive Function on the Functional Status of Intensive Care Unit Survivors: A Prospective Cohort Study

Son

Song

Seo

2020

J of Nursing Scholarship

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Purpose This study aimed to identify gender differences with regard to the impact of change in cognitive function on functional status 3 months after receiving critical care. Design and Methods This prospective cohort study investigated 152 intensive care unit (ICU) patients. Their functional status and cognitive function were assessed using the validated Korean version of the Modified Barthel Index and Mini‐Mental State Examination, respectively. Hierarchical regression was used to evaluate the impact of change in cognitive function on functional status in ICU survivors by gender. Findings The proportion of women suffering from consistent cognitive impairment was significantly higher than that of men. Women had a rate of improvement to normal cognitive function within 3 months after discharge that was higher than that of men. Functional status 3 months after discharge was significantly lower for patients whose cognitive impairment was consistent than that for those whose cognitive function was normal. The impact of change in cognitive function on men (R2 change = .28) was greater than that on women (R2 change = .13). Conclusions Persistent cognitive impairment after critical illness had a negative effect on functional status in ICU survivors. Importantly, the negative impact of consistent cognitive impairment was greater in men than in women. Clinical Relevance Early careful assessment of functional and cognitive status after critical illness is warranted. Strategies addressing the gender‐specific characteristics related to cognitive improvement should also be developed.

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“…Despite the dominant focus on medical disease perspective in acute illness and hospital systems, new models of care directed toward understanding the relationships of professional practice and human science are being advanced (Brewer & Watson, 2015;Stimpfel et al, 2014;Weyant et al, 2017). In particular, nursing care with an approach of understanding the human experience (Page, 2016) can be enhanced by incorporating narratives (van Manen, 2017). Developing and refining methods to help nurses gain understanding of the experiences of nursing care of families during an acute illness may be the catalyst for a change in their practice of interacting with families (Ellis et al, 2016).…”

Section: Gaining Understandings Through Narrativesmentioning

confidence: 99%

An Educational Intervention Incorporating Digital Storytelling to Implement Family Nursing Practice in Acute Care Settings

2020

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This project describes implementation of an educational intervention designed to initiate practice changes that support families and nurses during acute illness. An academic–practice partnership and digital storytelling methodology provided a foundation. A quasi-experimental research design included quantitative and qualitative measurement before and after the educational intervention. Themes identified in digital stories of nurse experiences caring for families provided direction for the educational intervention including the digital stories, empirical evidence, and proposed changes in nursing practice focused on families. Nurse participants ( n = 160) in the educational intervention reported positive responses on a qualitative questionnaire. Comparing pretest and posttest results of the Family Nurse Practice Scale reflected positive, though not significant change. Family members ( n = 49) reported significantly improved perceptions of support on 7 of the 14 items on the Iceland Perceived Family Support Questionnaire. This project highlighted digital storytelling’s power to promote family interventions and move family nursing knowledge into practice.

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Critical illness trajectory for patients, families and nurses – a literature review

Cited by 15 publications

References 89 publications

Adequacy of Protein and Energy Intake in Critically Ill Adults Following Liberation From Mechanical Ventilation Is Dependent on Route of Nutrition Delivery

Adequacy of Protein and Energy Intake in Critically Ill Adults Following Liberation From Mechanical Ventilation Is Dependent on Route of Nutrition Delivery

Gender Differences Regarding the Impact of Change in Cognitive Function on the Functional Status of Intensive Care Unit Survivors: A Prospective Cohort Study

An Educational Intervention Incorporating Digital Storytelling to Implement Family Nursing Practice in Acute Care Settings

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