Involving relatives in ICU patient care: The barriers … relatives in ICU patient care: The barriers and enablers Learning Objectives •To articulate reasons for relative inclusion

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Item type Presentation

Title Involving Relatives in ICU Patient Care: The Barriers andEnablers

Authors McConnell, Bridget Anne

Downloaded 13-Jul-2018 04:53:19

Link to item http://hdl.handle.net/10755/335136

Bridget McConnell- RN, BN (Hons)

Tracey Moroney-RN, BN (Hons), PhD, Grad Cert Ed Studies (Higher Ed)

MACN

Sydney, Australia

Involving relatives in ICU patient

care: The barriers and enablers

Learning Objectives

•To articulate reasons for relative inclusion and

exclusion

•Identify personal strengths and weaknesses in

regards to relative involvement in patient care

Why study this topic?

(Intensive Care Hotline, 2014)

Current literature• Relatives ICU experiences(Verhaeghe et al. 2005, McKiernan & McCarthy 2010, Cypress 2011, Eriksson et al. 2011)

• Relatives needs(Verhaeghe et al. 2005, El-Masri & Fox-Wasylyshyn 2007, Blanchard & Alavi 2008, Al-Mutair et al. 2013)

• The critical care nurse- relative relationship(Stayt 2007, Agård & Maindal 2009, Mitchell & Chaboyer 2010)

• ICU visiting policies(Farrell et al. 2005, Hunter et al. 2010, Agård & Lomborg 2011, Soury-Lavergne et al. 2011)

• The benefits of relative involvement(Williams 2005, Blanchard & Alavi 2008, Mitchell et al. 2009, Wåhlin et al. 2009, Hunter et al. 2010, Mitchell &

Chaboyer 2010, Agård & Lomborg 2011, Cypress 2011, Al-Mutair et al. 2013)

Research questions

1. In the critical care environment, what are the

barriers and/or enablers to nurses involving

relatives in patient care?

2. If barriers and/or enablers are found, why do

they exist?

Methodology and Methods

MIXED METHODS

Quantitative Qualitative Online questionnaire Interviews

Linking Phase 1 to

Phase 2

Results

Phase one

5.7%

18.6%

54.3%

17.1%

4.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Never Rarely Some of thetime

Most of thetime

Always

I involve family members in patient care.

Results

Phase two

1. The challenges of involvement

2. Insecurity

3. Care director

4. Hospital policies and liability

5. Benefits of involvement

6. Patient privacy

7. Decision making

8. The fragile relative

Discussion

The recognition of two nurses

1. The Gatekeeper (barriers)

2. The Facilitator (enablers)

The Gatekeeper

Gatekeeper

Role

Policies

Adverse Events

Insecurity

Patient Privacy

Time

The Facilitator

Facilitator

Resource

Benefits

Experience

Competency

Long termers

Veracity

Future

recommendations

• Further research into the barriers and enablers

• Education

• ICU policies and guidelines

• Multidisciplinary team

• Caregiver specialist

Final conclusions

• Improve relative satisfaction in the often

frightening intensive care environment

• Knowledge of barriers and enablers is likely to

assist in the practice of involving relatives in ICU

patient care

References•Agård AS & Lomborg K (2011) Flexible family visitation in the intensive care unit: Nurses'

decision-making. Journal of Clinical Nursing, 20, 1106-1114.

•Agård AS & Maindal HT (2009) Interacting with relatives in intensive care unit. Nurses'

perceptions of a challenging task. Nursing in Critical Care, 14, 264-272.

•Al-Mutair AS, Plummer V, O’Brien A & Clerehan R (2013) Family needs and involvement in

the intensive care unit: A literature review. Journal of Clinical Nursing, 22, 1805-1817.

•Blanchard D & Alavi C (2008) Asymmetry in the intensive care unit: Redressing imbalance

and meeting the needs of family. Nursing in Critical Care, 13, 225-231.

•Cypress BS (2011) The lived experience of nurses, patients and family members: A

phenomenological study with Merleau-Pontian perspective. Intensive and Critical Care

Nursing, 27, 273-280.

•El-Masri MM & Fox-Wasylyshyn SM (2007). Nurses’ roles with families: Perceptions of ICU

nurses. Intensive and Critical Care Nursing, 23, 43-50.

•Eriksson T, Bergbom I & Lindahl B (2011) The experiences of patients and their families of

visiting whilst in an intensive care unit- A hermeneutic interview study. Intensive and

Critical Care Nursing, 27, 60-66.

•Farrell ME, Joseph DH & Schwartz-Barcott D (2005) Visiting hours in the ICU: Finding the

balance among patient, visitor and staff needs. Nursing Forum, 40, 18-28.

•Hunter JD, Goddard C, Rothwell M, Ketharaju S & Cooper H (2010). A survey of intensive

care unit visiting policies in the United Kingdom. Journal of the Association of Anaesthetics of

Great Britain and Ireland, 65, 1101-1105.

•Intensive Care Hotline. (2014). [Image of ICU patient]. Retrieved from

http://intensivecarehotline.com/clinical-pictures/multi-trauma/

References•McConnell, B. (2013). Involving relatives in ICU patient care: The barriers and enablers, (Honours

thesis). University of Notre Dame, Australia, Sydney, N.S.W.

•McKiernan M & McCarthy G (2010) Family members’ lived experience in the intensive care

unit: A phemenological study. Intensive and Critical Care Nursing, 26, 254-261.

•Mitchell M, Chaboyer W, Burmeister E & Foster M (2009) Positive effects of a nursing

intervention on family-centred care in adult critical care. American Journal of Critical Care, 18,

543-552.

•Mitchell M.L & Chaboyer W (2010) Family centred care- A way to connect patients, families

and nurses in critical care: A qualitative study using telephone interviews. Intensive and

Critical Care Nursing, 26, 154-160.

•Soury-Lavergne A, Hauchard I, Dray S, Baillot M, Bertholet E, Clabault K, Jeune S, Ledroit C,

Lelias I, Lombardo V, Maetens Y, Meziani F, Reignier J, Souweine B, Tabah A, Barrau K &

Roch A (2011) Survey of caregiver opinions on the practicalities of family-centred care in

intensive care units. Journal of Clinical Nursing, 21, 1060-1067.

•Stayt LC (2007) Nurses’ experiences of caring for families with relatives in intensive

care units. Journal of Advanced Nursing, 57, 623-630.

•Verhaeghe S, Defloor T, Van Zuuren F, Duijnstee M & Grypdonck M (2005) The needs

and experiences of family members of adult patients in an intensive care unit: A review of the

literature. Journal of Clinical Nursing, 14, 501-509.

•Wåhlin I, Elk A & Idvall E (2009) Empowerment from the perspective of next of kin in intensive

care. Journal of Clinical Nursing, 18, 2580-2587.

•Williams CMA (2005) The identification of family members’ contribution to patients’ care in the

•intensive care unit: A naturalistic inquiry. Nursing in Critical Care, 10, 6-14.