Shared Decision-Making in Intensive Care Units. Executive Summary of the American College of Critical Care Medicine and American Thoracic Society Policy Statement

Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.

doi:10.1164/rccm.201602-0269ed

Cited by 183 publications

(268 citation statements)

References 22 publications

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“…3 The goal of shared decision-making is to make decisions consistent with the patient's wishes. 3,14 To be involved in shared decision-making, families should be informed of the short-and long-term plans of care. Setting expectations and preparing for the future was a major factor that influenced how well making a connection occurred.…”

Section: Discussionmentioning

confidence: 99%

“…Involving the family in the bedside rounding process and decision making, and educating them about how best to support the patient may be beneficial. 3 To increase family awareness about rounds, an informational flier should be developed and given to family members upon their loved one's admission to the ICU. This simple intervention has been recommended to improve communication and decrease stress.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, we rarely study family members' perspectives, such as their view of the illness, their future role in the management of the condition, and/or family functioning overall.…”

mentioning

confidence: 99%

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Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

Cody

Sullivan-Bolyai

Reid-Ponte

2018

Critical Care Nurse

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BACKGROUND The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. OBJECTIVES To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. METHODS A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. RESULTS Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confi dence, emerged from participating families. Two major factors infl uenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identifi ed: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. CONCLUSION What health care providers say to patients' families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information. (Critical Care Nurse. 2018; 38[3]:18-26) This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1. Describe the elements of consistency that are important to family members who wish to participate in bedside rounds 2. Identify 3 benefi ts of including family members in bedside rounds 3. Describe the potential adverse consequences experienced by families who do not participate in bedside roundsTo complete evaluation for CE contact hour(s) for activity C1831, visit www.ccnonline.org and click the "CE Articles" button. No CE fee for AACN members.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

Cody

Sullivan-Bolyai

Reid-Ponte

2018

Critical Care Nurse

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“…While the French law authorizing such practices was passed in 2005, the prevalence of advance directives and designated surrogate persons remains low (53). When patients in the ICU lack decision-making capacity, WhWd discussions are often shared between physicians, nurses, and family members or relatives acting as surrogates and representing the patient's values and preferences (67,68). Once a WhWd decision has been made, a physician who has no direct knowledge of the deceased's wishes must question the relatives about a possible consent/opposition to organ or tissue donation expressed during the patient's lifetime.…”

Section: Caregivers Have Equal Responsibility Towards Both the Dyingmentioning

confidence: 99%

A few realistic questions raised by organ retrieval in the intensive care unit

Lesieur¹,

Genteuil²,

Leloup³

2017

Ann. Transl. Med.

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Organ transplantation saves the lives of many persons who would otherwise die from end-stage organ disease. The increasing demand for donated organs has led to a renewed interest in donation after circulatory determination of death (CDD). In many countries (including France), terminally ill patients who die of circulatory arrest after a planned withdrawal of life support may be considered as organ donors under certain conditions. While having equal responsibility towards the potential donor and the persons awaiting a transplant, caregivers may experience an ethical dilemma between the responsibility to deliver the best care to the dying, and the need to retrieve the organs. Once it has been established that the patient wishes to be a donor, we assume that end-of-life care and organ donation may have convergent goals when they contribute to transforming a comfortable death into a chance of life for others in need.

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“…[15][16][17] Additionally, critical care pharmacists performing higher level services have improved job satisfaction. 18 The data collected by critical care pharmacists will be amenable to economic analyses.…”

Section: Sample Value Of the Proposed Servicementioning

confidence: 99%

Developing a Business Plan for Critical Care Pharmacy Services

2016

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Critical care medicine has grown from a small group of physicians participating in patient care rounds in surgical and medical intensive care units (ICUs) to a highly technical, interdisciplinary team. Pharmacy's growth in the area of critical care is as exponential. Today's ICU requires a comprehensive pharmaceutical service that includes both operational and clinical services to meet patient medication needs. This article provides the elements for a business plan to justify critical care pharmacy services by describing the pertinent background and benefit of ICU pharmacy services, detailing a current assessment of ICU pharmacy services, listing the essential ICU pharmacy services, describing service metrics, and delineating an appropriate timeline for implementing an ICU pharmacy service. The structure and approach of this business plan can be applied to a variety of pharmacy services. By following the format and information listed in this article, the pharmacy director can move closer to developing patient-centered pharmacy services for ICU patients.

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Shared Decision-Making in Intensive Care Units. Executive Summary of the American College of Critical Care Medicine and American Thoracic Society Policy Statement

Cited by 183 publications

References 22 publications

Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

A few realistic questions raised by organ retrieval in the intensive care unit

Developing a Business Plan for Critical Care Pharmacy Services

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