Development of a Family Engagement Measure for the Intensive Care Unit

Goldfarb, Michael; Debigaré, Sylvie; Foster, Nadine E; Soboleva, Nataliya; Desrochers, France; Craigie, Laura; Burns, Karen E. A.

doi:10.1016/j.cjco.2022.07.015

Cited by 7 publications

(9 citation statements)

References 15 publications

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“…A novel tool to measure engagement in critical care practice, the Family Engagement instrument, was developed and awaiting validation within the CICU setting. 26 An engagement measure could potentially be used to benchmark engagement performance internally and between CICUs. There is a need to explore the longitudinal family involvement in multidisciplinary teams in the CICU, such as the heart team or shock team.…”

Section: Discussionmentioning

confidence: 99%

Family Engagement in the Adult Cardiac Intensive Care Unit: A Survey of Family Engagement Practices in the Cardiac Critical Care Trials Network

Goldfarb

Alviar

Berg

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND: Cardiovascular and critical care professional societies recommend incorporating family engagement practices into routine clinical care. However, little is known about current family engagement practices in contemporary cardiac intensive care units (CICUs). METHODS: We implemented a validated 12-item family engagement practice survey among site investigators participating in the Critical Care Cardiology Trials Network, a collaborative network of CICUs in North America. The survey includes 9 items assessing specific engagement practices, 1 item about other family-centered care practices, and 2 open-ended questions on strategies and barriers concerning family engagement practice. We developed an engagement practice score by assigning 1 point for each family engagement practice partially or fully adopted at each site (max score 9). We assessed for relationships between the engagement practice score and CICU demographics. RESULTS: All sites (N=39; 100%) completed the survey. The most common family engagement practices were open visitation (95%), information and support to families (85%), structured care conferences (n=82%), and family participation in rounds (77%). The median engagement practice score was 5 (interquartile range, 4). There were no differences in engagement practice scores by geographic region or CICU type. The most commonly used strategies to promote family engagement were family presence during rounds (41%), communication (28%), and family meetings (28%). The most common barriers to family engagement were COVID-related visitation policies (38%) and resource limitations (13%). CONCLUSIONS: Family engagement practices are routinely performed in many CICUs; however, considerable variability exists. There is a need for strategies to address the variability of family engagement practices in CICUs.

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Section: Discussionmentioning

confidence: 99%

Family Engagement in the Adult Cardiac Intensive Care Unit: A Survey of Family Engagement Practices in the Cardiac Critical Care Trials Network

Goldfarb

Alviar

Berg

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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“…However, important differences exist between family members in the adult ICU compared with the PICU or neonatal ICU context, including family participant age, relationship, and role. Family members are much older in the adult ICU; the mean age of family member participants was 30 years old in one neonatal ICU study (32) compared with 52 years old in an adult ICU study (33). In the neonatal/PICU, family are almost exclusively parents or surrogates, whereas in the adult ICU, the most prevalent relationships are adult child, spouses/partners, and siblings (32, 33).…”

Section: Discussionmentioning

confidence: 99%

“…Family members are much older in the adult ICU; the mean age of family member participants was 30 years old in one neonatal ICU study (32) compared with 52 years old in an adult ICU study (33). In the neonatal/PICU, family are almost exclusively parents or surrogates, whereas in the adult ICU, the most prevalent relationships are adult child, spouses/partners, and siblings (32, 33). In addition, the family role also differs considerably between the settings (i.e., breastfeeding/lactation vs support during procedures, delirium reorientation).…”

Section: Discussionmentioning

confidence: 99%

Family Presence on Rounds in Adult Critical Care: A Scoping Review

Calderone

Debay

Goldfarb

2022

Critical Care Explorations

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OBJECTIVES: Family presence on rounds involves allowing family members to participate in daily healthcare team rounds and is recommended by critical care professional societies. Yet, family presence on rounds is not performed in many institutions. There is a need to synthesize the current evidence base for this practice to inform healthcare providers of the potential benefits and challenges of this approach. The main objective of this study was to explore the impact of family presence on adult ICU rounds on family and healthcare providers.DATA SOURCES: Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and PubMed databases were last searched on January 28, 2022. Studies published during the COVID-19 pandemic were included. STUDY SELECTION:Studies involving family presence during rounds that included family or healthcare provider perspectives or outcomes were selected. There were no limitations on study design. DATA EXTRACTION:Qualitative and quantitative family and provider perspectives, barriers and challenges to family presence, and study outcomes were extracted from studies. The JBI Manual for Evidence Synthesis published guidelines were followed.DATA SYNTHESIS: There were 16 studies included. Family reported family presence on rounds as a means of information transfer and an opportunity to ask care-related questions. Family presence on rounds was associated with increased family satisfaction with care, physician comfort, and improved physician-family relationship. Healthcare providers reported a positive perception of family presence on rounds but were concerned about patient confidentiality and perceived efficacy of rounds. Family presence was found to increase rounding time and was felt to negatively impact teaching and opportunities for academic discussions. CONCLUSIONS:Family presence on rounds has potential advantages for family and healthcare providers, but important challenges exist. Further studies are needed to understand how to best implement family presence on adult ICU rounds.

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“…It is a key factor in the efficiency and effectiveness of health care systems, contributing to an enhanced overall quality of care. 11 Failure to understand families' needs and challenges may worsen their burdens. Acknowledging the concerns of families with loved ones hospitalized in the ICU and actively engaging them contribute to improved patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Experiences of family members when accompanying patients in intensive care units: A qualitative study

Abdollahimohammad,

Rahnama,

Firouzkouhi

2024

Nursing in Critical Care

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BackgroundFamily members of Intensive Care Unit (ICU) patients encounter numerous challenges while providing companionship to their hospitalized loved ones.Aims and ObjectivesThis study aims to explore the experiences of family members with loved ones hospitalized in ICUs.DesignQualitative research was conducted using a content analysis approach.ParticipantsTen family members of ICU patients were recruited using purposive sampling.MethodsData were collected through semi‐structured, in‐depth interviews and analysed following Graneheim and Lundman's suggested steps.FindingsAnalysis of interviews with ten family members of ICU patients revealed a theme of “challenging companionship on an obscure path,” encompassing four categories (1–4) and nine subcategories (a, b and c). These included (1) the interplay between the patient and the family: a. family affected by the patient's condition; b. patient affected by the family's condition; (2) mixed emotions of apprehension and anticipation regarding ICU admission: a. fear of ICU hospitalization; b. hope for ICU hospitalization; (3) unaddressed needs and concerns: a. pressure from the ICU's visiting limitations; b. lack of a resting room to settle; c. vague information about the patient's condition; (4) two‐way care suffering for families a. direct suffering associated with companionship; b. indirect suffering while observing the patients' suffering.ConclusionsFamilies of ICU patients encounter various challenges, revealing the complex interplay of emotions, needs and challenges within the ICU. This highlights the intricate dynamics in this critical health care environment.Relevance to Clinical PracticeA holistic and empathetic approach in clinical practice is crucial in ICU care, particularly during the challenging journey patients and their families undergo in this critical setting. Health care systems and providers should adapt ICU rules to address evolving needs, alleviate concerns and enhance the overall family experience during their loved one's hospitalization in the ICU.

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Development of a Family Engagement Measure for the Intensive Care Unit

Cited by 7 publications

References 15 publications

Family Engagement in the Adult Cardiac Intensive Care Unit: A Survey of Family Engagement Practices in the Cardiac Critical Care Trials Network

Family Engagement in the Adult Cardiac Intensive Care Unit: A Survey of Family Engagement Practices in the Cardiac Critical Care Trials Network

Family Presence on Rounds in Adult Critical Care: A Scoping Review

Experiences of family members when accompanying patients in intensive care units: A qualitative study

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