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

Abstract

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

Implementation of a multicomponent family support intervention in adult intensive care units: study protocol for an embedded mixed-methods multiple case study (FICUS implementation study)

“…In contrast, leadership support, clear and accurate communication, and engagement of the healthcare team are described as the most important facilitators. [14][15][16][17][18][19][20][21][22][23][24] However, intervention research around FSIs in ICUs has not investigated their implementation, 12 25 26 except for one ongoing trial, which will explore implementation processes and outcomes. 27 The implementation of complex interventions, such as FSIs, is challenging as they contain several independently and interdependently interacting components at the individual behavioural, interprofessional team and organisational level.…”

Tailored implementation of the FICUS multicomponent family support intervention in adult intensive care units: findings from a mixed methods contextual analysis

“…Research has identified organizational, team, staff, and family-related determinants to shape the uptake of evidence-based practices in routine care delivery [ 24 – 27 ]. For example, at the organizational level, leadership and organizational support, physical layouts, staffing levels, and time capacity are key determinants to family care and frequent barriers [ 28 – 32 ]. At the team level, interprofessional team commitment and established care structures, such as regular family meetings or open visitation policies for families, were consistently identified as enablers, whereas perceptions of families as interrupters coupled with lower educational levels pose barriers [ 28 , 30 , 32 – 34 ].…”

“…For example, at the organizational level, leadership and organizational support, physical layouts, staffing levels, and time capacity are key determinants to family care and frequent barriers [ 28 – 32 ]. At the team level, interprofessional team commitment and established care structures, such as regular family meetings or open visitation policies for families, were consistently identified as enablers, whereas perceptions of families as interrupters coupled with lower educational levels pose barriers [ 28 , 30 , 32 – 34 ]. At the family level, language, health literacy, complex or conflictual family structures and dynamics, together with patient acuity, hinder the uptake of evidence-based family care processes [ 25 , 30 – 32 ].…”

What counts as patient-important upper gastrointestinal bleeding in the ICU? A mixed-methods study protocol of patient and family perspectives

“…[4][5][6] Ethically and scientifically compelling, patient involvement in critical care research can build on a proliferation of strategies for meaningful involvement of patient partners in health research to help ensure that the study outcomes are relevant and meaningful to future patients. [6][7][8][9][10] In service of this tenet, there is a need to create a measure of upper gastrointestinal bleeding that is important to patients and their families. In critically ill patients, minor bleeding is extremely…”