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Family Participation in CICU Rounds: RCT

Not Applicable
Conditions
Family Members
Engagement, Patient
Health Care Providers
Interventions
Other: Direct participation of the family member in the daily rounds
Registration Number
NCT05528185
Lead Sponsor
Lady Davis Institute
Brief Summary

This is a single-center, unblinded, pragmatic randomized controlled trial comparing family participation in cardiac ICU team rounds with usual care. We will recruit 112 family members. The primary outcome will be family member care satisfaction. Secondary outcomes will include family mental health and care engagement. The beliefs, attitudes, and knowledge of healthcare providers, including medical trainees, about family participation in rounds will be evaluated prior to and following the intervention.

Detailed Description

This is a single-center (Jewish General Hospital), unblinded, pragmatic randomized controlled trial comparing family participation in the Cardiac Intensive Care Unit (CICU) team rounds with usual care.

Research team will recruit family members and health care providers in the Cardiac Intensive Care Unit (CICU) at the Jewish General Hospital. Family members will be randomized in a 1:1 ratio to either the intervention or usual care using the REDCap randomization module. The intervention consists of family invitation and participation in team rounds during the patient's stay in the CICU. Family may participate in-person or virtually. Usual care consists of interdisciplinary team rounds that occur outside the patient's room each morning without family presence.

A research team member will approach the participating family member to distribute the follow-up survey after transfer of the patient to the cardiovascular ward or prior to hospital discharge if the patient will be discharged from the hospital directly from the CICU. The follow-up survey will be composed of the FS-ICU, HADS, and FAME surveys. The perspectives of healthcare providers, including medical trainees, prior to and after the intervention will be assessed through the QFIFE survey.

An increase in the mean family care satisfaction score, as measured by the Family Satisfaction in the ICU survey (FS-ICU) is hypothesized for family members participating in team rounds. A positive change in attitudes and knowledge of healthcare providers and medical trainees following family participation in rounding is also expected.

The proposed study will generate much needed evidence for the effectiveness of a family rounding strategy to improve family-centered outcomes in the cardiac ICU. The evidence derived from this study could support the practice of family participation in team rounding and inform clinicians about the potential benefits of this approach.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
220
Inclusion Criteria
  • expected patient length of stay >48 hours
  • family member, as designated by the patient or surrogate decision maker
  • able to participate in English or French
  • willingness to participate in morning rounds
Exclusion Criteria
  • another family member has already participated in the study
  • inability to provide informed consent in English or French

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionDirect participation of the family member in the daily roundsThe intervention consists of family participation in morning interdisciplinary team rounds in the cardiac ICU. Family participation will consist of orientation, engagement, summary, questions, and communication follow-up by the care team.
Primary Outcome Measures
NameTimeMethod
Family Care Satisfaction as Measured by the FS-ICU Survey.Within 2 weeks of cardiac ICU discharge

A mean improvement change in Family Satisfaction in the ICU (FS-ICU 24R) survey score in family members participating in rounds (intervention). The survey assesses family satisfaction with care in the ICU setting and is given at the end of the patient's stay in the Cardiac Intensive Care Unit. Survey scores are reported with a range of 0-100, where higher scores indicate increased satisfaction with care.

Secondary Outcome Measures
NameTimeMethod
Family Engagement in Care as Measured by the FAMily Engagement (FAME) SurveyWithin 2 weeks of cardiac ICU discharge

The survey assesses perception of engagement, family presence, communication/education, decision-making, contributing to care, family-centered care, and family needs. A five-point Likert scale is used for response. Scale results are then transformed to a 0-100 scoring system, with higher scores indicating greater engagement in care and lower scores indicating lesser engagement in care.

Change in Attitudes and Knowledge of Healthcare Providers as measured by the QFIFE surveyThrough study completion, up to 4 weeks

The Questionnaire on Factors That Influence Family Engagement (QFIFE) assesses the perspectives of healthcare providers and medical trainees. Health care providers will take the QFIFE questionnaire (pre-intervention) prior to their first exposure to the intervention. At the end of the intervention period, participating health care providers will take the QFIFE questionnaire a second time (post-intervention).

Family Mental Health as Measured by the Hospital Anxiety and Depression Scale (HADS) SurveyWithin 2 weeks of cardiac ICU discharge

The Hospital Anxiety and Depression Scale (HADS) is a self-reported tool to measure anxiety and depression in medical patients. It is composed of 14 questions (7 depression-related and 7 anxiety-related) on a 4-point Likert scale (range 0-3). The total score is the sum of the 14 questions, and for each subscale the score is the sum of the respective 7 questions.

Trial Locations

Locations (1)

Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

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