Involving relatives in <scp>ICU</scp> patient care: critical care nursing challenges

McConnell, B; Moroney, Tracey

doi:10.1111/jocn.12755

Cited by 52 publications

(71 citation statements)

References 24 publications

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“…Other studies have cited legal issues, inadequate procedural guidelines, and lack of nursing education related to family involvement as significant barriers to implementing family engagement practices. 2,22 Current guidelines exist for family support 9,10 ; however, most organizations have not instituted all recommended practices for family care in the ICU. Family participation requires a systematic assessment of organizational and unit-based family care philosophies and family support resources.…”

Section: Discussionmentioning

confidence: 99%

“…This investigator-developed instrument was derived from a review of the literature and 2 established measures. 2,19 The QFIFE is a 15-item questionnaire that consists of 4 subscales: (1) ICU environment (items 1–5), (2) patient acuity (items 6–7), (3) nurse workflow (items 8–10), and (4) attitude toward family caregiver engagement in care (items 11–15). These subscales measure the nurse perceptions of the physical environment and culture of the ICU, clinical stability of the patient, disruptive workflow, and the attitude toward family engagement in the delivery of ICU care.…”

Section: Methodsmentioning

confidence: 99%

“…However, the literature provides evidence that critical care nurses express resistance to involving family caregivers because of misconceptions such as families’ interfering with care, exhausting the patient, and spreading infection. 2,19–21 Nurses have expressed concerns regarding the safety of family engagement in care in relationship to patients’ severity of illness and their fluctuations in acuity while receiving care in the ICU. 2,4,14,18,20,22,23 …”

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confidence: 99%

“…2,4,14,18,20,22,23 Further exploration of these factors will help inform the promotion of patient and family engagement in the ICU and identify strategies to help nurses embrace family caregivers as active participants in patient care.…”

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confidence: 99%

“…To guide this study, a conceptual model (Figure 1) was developed with evidence from empirical studies of factors that facilitate the inclusion of caregivers in direct patient care activities in the ICU and beyond. 2,4,14,18,20,22,23 Model assumptions are that the ICU environment of care and patient acuity affect nursing workflow and nurses’ attitudes toward family engagement in care. Individual, intrinsic nurse and organizational factors may also influence nurses’ attitudes toward family engagement in care.…”

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confidence: 99%

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Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Hetland

Hickman

McAndrew

et al. 2017

AACN Advanced Critical Care

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Critical care nurses are vital to promoting family engagement in the intensive care unit. However, nurses have varying perceptions about how much family members should be involved. The Questionnaire on Factors That Influence Family Engagement was given to a national sample of 433 critical care nurses. This correlational study explored the impact of nurse and organizational characteristics on barriers and facilitators to family engagement. Study results indicate that (1) nurses were most likely to invite family caregivers to provide simple daily care; (2) age, degree earned, critical care experience, hospital location, unit type, and staffing ratios influenced the scores; and (3) nursing workflow partially mediated the relationships between the intensive care unit environment and nurses' attitudes and between patient acuity and nurses' attitudes. These results help inform nursing leaders on ways to promote nurse support of active family engagement in the intensive care unit.Keywords critical care; family caregivers; family-centered nursing; family engagement An increasing number of Americans require treatment in the intensive care unit (ICU), and a proportional increase in family caregivers will assume caregiving responsibilities that can have persistent negative effects on their health and overall quality of life. [1][2][3][4][5][6] The conventional ICU care paradigm has primarily targeted the informational needs of family Breanna Hetland is Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH (bdh66@case.edu). HHS Public AccessAuthor manuscript AACN Adv Crit Care. Author manuscript; available in PMC 2017 September 07. Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript caregivers of the critically ill, but has not addressed how to actively engage caregivers in other aspects of the ICU experience such as symptom assessment and the direct provision of care. [7][8][9][10] Although critical care research, policy, and practice guidelines 9,10 increasingly recognize family caregivers as part of a larger patient-provider interaction during critical illness, the literature on family caregiver engagement in this context mainly focuses on passive forms of involvement such as family presence, communication, and decisionmaking. Few studies address family caregivers' active contributions to patient care. 7,8,[11][12][13][14][15][16][17][18] Patient and family engagement are defined as active partnerships among health care providers, patients, and families. 7 Identifying effective ways to implement patient and family engagement is paramount to improving the patient and family experience as well as improving safety, quality, and delivery of care. [7][8][9] In the ICU, critical care nurses are the frontline providers of life-sustaining care and key staff members in promoting patient and family engagement. However, the literature provides evidence that critical care nurses express resistance to involving family caregivers because of misconception...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Hetland

Hickman

McAndrew

et al. 2017

AACN Advanced Critical Care

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Family engagement in the care of infectious patients in intensive care units: A hybrid concept analysis

Soleimani,

Fakhr‐Movahedi,

Yarahmadi

2024

Nursing Open

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AimThis study aims to define and investigate characteristics, antecedents, and consequences of the concept of family engagement in caring for patients with infectious diseases hospitalised in intensive care units.DesignThis is a three‐phase hybrid model study (theoretical, fieldwork, and analytical phase).MethodsThe York University Guidelines were used in the theoretical phase, and ultimately, 16 pieces of literature related to the subject under study from 2011 to 2021 were reviewed. The content analysis was used for fieldwork phases; eight participants were interviewed. Then, the theoretical and fieldwork findings were compared, integrated, and analysed.ResultsThis concept has characteristics such as; awareness, belief, perception, and willingness of the nurse to engage the family; a sense of responsibility, willingness, and sacrifice of the family; the physical or virtual presence of the family; triangular interaction between the nurse, patient, and family; perception and identifying the goals; education and information transfer; team collaboration; delegation of responsibility to the family; decision making; and protection of the family. Antecedents include the availability of infrastructure; patient, family, and nurse conditions; and the quality implementation of engagement. The consequences include positive consequences related to the patient, family, nursing, and society, as well as some negative consequences. This study provided a comprehensive perception of family engagement in the care of patients with infectious diseases in intensive care units and defined it more clearly, showing its characteristics, antecedents, and consequences.Patient or Public ContributionEight participants were interviewed, including five nurses, two family caregivers, and one patient.

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Patient and family engagement in patient care and research in Canadian intensive care units: a national survey

Burns

McDonald

Debigaré

et al. 2022

Can J Anesth/J Can Anesth

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Purpose While patient and family engagement may improve clinical care and research, current practices for engagement in Canadian intensive care units (ICUs) are unknown. Methods We developed and administered a crosssectional questionnaire to ICU leaders of current engagement practices, facilitators, and barriers to engagement, and whether engagement was a priority, using to an ordinal Likert scale from 1 to 10. Results The response rate was 53.4% (124/232). Respondents were from 11 provinces and territories, mainly from medical surgical ICUs (76%) and community hospitals (70%). Engagement in patient care included bedside care (84%) and bedside rounds (66%), presence during procedures/crises (65%), and survey completion (77%). Research engagement included ethics committees (36%), protocol review (31%), and knowledge translation (30%). Facilitators of engagement in patient care included family meetings (87%), open visitation policies (81%), and engagement as an institutional priority (74%). Support from departmental (43%) and hospital (33%) leadership was facilitator of research engagement. Time was the main barrier to engagement in any capacity. Engagement was a higher priority in patient

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Involving relatives in ICU patient care: critical care nursing challenges

Abstract: Knowledge of the barriers to relative involvement in critically ill patient care may provide a basis for improving discussion on this topic and may assist intensive care units to implement strategies to reduce barriers.

Cited by 52 publications

References 24 publications

Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Factors Influencing Active Family Engagement in Care Among Critical Care Nurses

Family engagement in the care of infectious patients in intensive care units: A hybrid concept analysis

Patient and family engagement in patient care and research in Canadian intensive care units: a national survey

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