The future of families in ICU -The positive effects of partnering with families

Abstract

THE FUTURE OF FAMILIES IN ICU – THE POSITIVE EFFECTS OF PARTNERING WITH FAMILIES

Marion L. Mitchell1, Wendy Chaboyer1, Liz Burmeister2, Michelle Foster3 1School of Nursing and Midwifery, Research Centre for Clinical and Community Practice Innovation, Griffith University, Brisbane, Australia; 2 ICU, Princess Alexandra Hospital, Brisbane, Australia; 3ICU, Gold Coast Hospital, Southport, Australia.

Generally, families are not actively involved in ICU patients' care in meaningful ways. A Family-Centred-Care (FCC) model formalises the family and patient as the unit of care. FCC is comprised of three concepts - respect, collaboration and support. This study evaluated the effects on FCC of ICU nurses partnering with families to provide fundamental care. A pre-test, post-test design was used with families at the control site experiencing usual conditions whereas those at the intervention site were invited to assist with their relative's care. All participants provided written consent. The FCC survey measured families' perceptions of respect, collaboration and support at baseline and then 48 hours. A total of 174 family members participated (75 control, 99 intervention). Total FCC sores at baseline were 3.19 (control) and 3.39 (intervention) and at follow-up were 3.18 (control) and 3.46 (intervention) (range1-5). Multivariate logistic regression identified independent predictors of FCC scores. After pre-test score, the FCC intervention was the strongest predictor of post-test score. Other predictors included when the patient was female and the patient's partner (Table 1). This study indicates that ICU nurses partnering with family members to provide fundamental care significantly improved family's perceptions of respect, collaboration and support. FCC provides a model for future improvements to families' experience of ICU.

TABLE 1: Predictors of Post-test FCC Survey

Total FCC Variable (reference group) OR (95% CI) p Pre-test score5.48 (4.9-6.12)<.001 Group (control )1.66 (1.4-1.97)<.001 Patient Gender (male)1.48 (1.21-1.80)<.001 Partner 1.33 (1.11-1.58)0.002 ICU Experience1.27 (1.07-1.50)0.006