Effectiveness of Critical Care Discharge Information in Supporting Early Recovery From Critical Illness

Abstract

Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. Overall evidence was of low quality but use of individualized information was associated with beneficial physical effects for patients and increased knowledge and satisfaction for their relatives. Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users’ needs are discussed. Results should inform the design of future studies on this topic.

A review of interventions supporting parent's psychological well‐being after a child's intensive care unit discharge

“…In line with data from the adult population (Bench et al, ), a key finding was the need for appropriate information to raise awareness of the prevalence of symptoms and to signpost appropriate support resources (Gledhill et al, ). The provision of personalized discharge information has been shown to be feasible and valued by adult ICU survivors, family members and health care staff (Bench et al, ; Bench et al, ), although its impact on health outcomes remains unknown (Bench et al, ).…”

“…Making people aware of the prevalence of symptoms and advising them on how to get help would be a very achievable first step for most units. This could be conducted by providing information leaflets to parents, which include contact details for parent support organizations and primary care providers (Bench et al, ; Purdy and Zeanah, ). Such leaflets, detailing the increased risk of developing psychological symptoms and advice on what to do should they experience symptoms, could be handed out to all families on discharge from PICU.…”

Evaluating the feasibility and effectiveness of a critical care discharge information pack for patients and their families: a pilot cluster randomised controlled trial

“…Providing information is an important element of effective critical illness rehabilitation care, 1 2 yet at the time of discharge from an intensive care unit (ICU) to a general care environment (ward), some patients and relatives report not receiving any information 3 4 or receiving ad hoc verbal information, sometimes accompanied by a leaflet or booklet. 5 …”

“… 11 Any written information must also acknowledge the heightened anxiety experienced by both patients and relatives at this time 11 and reflect the differing information needs of both groups at various time points. 4 5 Our intervention was designed to address all of these elements, in contrast to the interventions described in the few studies which have previously evaluated written ICU discharge information resources. 12–15 …”

Organizing Safe Transitions from Intensive Care

“…Patients want to feel safe and secure both before and after the transfer [6], and they can easily become dependent on the staff [7]. There are studies that describe how patients perceive their safety during transfer and how they feel about their recovery [8], but it has also been reported how perceived physical illness can affect experiences of displacement.…”