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

Abstract

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.

Family Members' Engagement in Symptom Communication, Assessment, and Management in the Intensive Care Unit

“…26 In existing literature, family members' contribution in the ICU is commonly described as either family participation, 27 family involvement, 2,12 or family engagement. 28 For this study, family engagement is considered the proper term to use, as the researchers understand "engagement" as more proactive than "participation" or "involvement." There is a gap in knowledge about family members' engagement in symptom communication, assessment, and management.…”

“…A review of family members' role in pain management in the ICU concluded that family members were willing and capable of contributing in pain assessment and management, but research on this topic was scarce 26 . In existing literature, family members' contribution in the ICU is commonly described as either family participation, 27 family involvement, 2,12 or family engagement 28 . For this study, family engagement is considered the proper term to use, as the researchers understand “engagement” as more proactive than “participation” or “involvement.” There is a gap in knowledge about family members' engagement in symptom communication, assessment, and management.…”