Family Presence on Multidisciplinary Patient Care Rounds in ICU
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 390
- 试验地点
- 2
- 主要终点
- Assessing Family Satisfaction Change after Inclusion in patient-and-family-centered rounds using the Critical Care Family Satisfaction Survey (CCFSS) scale
研究概览
简要总结
Family presence on patient care rounds in adult intensive care units remains the least studied area of family-centered care. Despite support from professional organizations and critical care experts, very few critical care units in the United States have written policies allowing family presence (Davidson, 2013). This multidisciplinary prospective, quasi-experimental design study examined if there is a difference in patient and family satisfaction between rounding in the presence of family compared to patient rounding without family members in the adult intensive care unit and determined the nurses' and health care professionals' attitudes toward family presence during multidisciplinary patient care rounds in the ICU of two hospitals. The sample was 150 patients and family members (75 per hospital) and a convenience sampling of 90 healthcare professionals from the two sites. This investigation will have a potential impact on nursing practice and research. Findings obtained from this study may provide further concrete information on the effect of family presence during multidisciplinary patient care rounds, and patient and family satisfaction that will develop policies and standardized approaches to rounding processes that are innovative in diverse critical care settings as well as other non-critical care settings. Data obtained from this research will be used to create patient and family-centered care plans, add new knowledge and educational programs for healthcare professionals
详细描述
Purpose/Specific Aims The overall goal of this multidisciplinary, multisite quasi-experimental study was to determine whether family presence and engagement during patient-and-family-centered interdisciplinary rounds (PFCC-IR) impacts nurses' and health care professionals' attitudes and patient and family satisfaction with their intensive care unit (ICU) stay. A. Objectives
(1) To examine if there is a difference in patient and family satisfaction between rounding in the presence of family compared to patient rounding without family members in the adult intensive care unit (ICU) using the Patient Satisfaction with Nursing Care Quality Questionnaire ([PSNCQQ], and the Critical Care Family Satisfaction Survey ([CCFSS]; and, (2) To determine ICU nurses' and health care professionals' attitudes toward family presence during PFCC-IR using the Families' Importance in Nursing Care-Nurse's Attitudes ([FINC-NA] scale
B. Hypotheses / Research Question(s) The present study hypothesized that:
H1: There will be greater patient satisfaction when rounding with family present compared to without family present. H2: There will be differences in attitudes towards family presence during PFCC-IR.
Research Design and Methods: This multisite quasi-experimental study was conducted in an adult ICU of two hospitals in southern New Jersey. Approval from the Institutional Review Board (IRB) was obtained before the initiation of the study. Informed consent was obtained from the patients, family members, nurses, and health care professionals. The sample consists of 150 patients and family members (75 dyads per hospital) and 90 healthcare professionals (n = 390 total) that included the ICU Attendings/Intensivists, Fellows, medical residents, respiratory therapists, physical therapists, pharmacists, dietitians and a social worker. Three instruments were used: the FINC-NA, the PSNCQQ, and the CCFSS. The PFCC-IR were led by the ICU Attending or Intensivist. Duration for Study and Each Subject: The patient and family members' participation in the study took 30 minutes to one hour for the rounds, and another 20-30 minutes to complete the survey for an overall total participation time of 2.5 hours.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patients admitted to the adult ICU over the age of 20 who are awake and alert with a score of above 25 on the Mini-Mental Status (MMS) examination, able to provide informed consent, fill out the questionnaires and who has a family member or significant other who will be willing to participate in the study.
- •Family members who are in the patient's primary support system and or caregiver, significant other, or those whom the patient considered or identified as the family who are over the age of 20, able to provide informed consent and will be willing to attend the multidisciplinary rounds while their patient is in the ICU and fill-out the questionnaires.
- •All ICU nurses and other health care professionals such as the physicians, respiratory therapists, social workers, and dietitians over the age of 25, male and female nurses, working full time in the ICUs, and willing to provide informed consent will be surveyed.
排除标准
- •Any patient with an MMS score below 25 will not be included in the study.
- •Patients who are admitted in cardiogenic shock or who are hemodynamically unstable, who are 'intubated' and on mechanical ventilation will be excluded from the study, and with an MMS score of below 20 will be excluded in the study.
- •Family members and nurses who are unwilling or will refuse to participate in multidisciplinary rounds will be excluded.
结局指标
主要结局
Assessing Family Satisfaction Change after Inclusion in patient-and-family-centered rounds using the Critical Care Family Satisfaction Survey (CCFSS) scale
时间窗: Baseline (day 1 when in the study) and post-intervention(4 days after the patient leave the ICU)
The 5 subscales of the CCFSS are assurance, proximity, support, comfort, and information. The Cronbach alpha for the total scale was 0.96 and 0.74 - 0.92 for the subscales (Roberti \& Fitzpatrick, 2010). When administering the CCFSS, the respondent endorses one of five choices from 1 (very dissatisfied) to 5 (very satisfied) for each of the 20 items. A mean subscale score is calculated for each subscale (range 1 to 5), and a total satisfaction score (range 5 to 25) is computed by summing the five subscale scores. Higher scores for the subscale and total satisfaction scores indicate a greater satisfaction as perceived by a patient's family member (Wasser \& Matchett, 2001; Wasser et al., 2001, 2004)
Assessing Patient Satisfaction Change after Inclusion in patient-and-family-centered rounds using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) scale
时间窗: Baseline (day 1 when in the study) and post-intervention (4 days after the patient leave the ICU)
Patient satisfaction with ICU stay was assessed using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) scale. The instrument is a 19-item questionnaire. Cronbach's reliability estimates of 0.97. Participants' responses are provided using a 5-point Likert-type scale. Total possible scores range from 19-95. Lower total scores indicate greater satisfaction with nursing care. The scoring of the scale was: 1 = excellent, 2 = very good, 3 = good, 4 = fair, 5 = poor
Assessing attitudes of healthcare professionals using the Families' Importance in Nursing Care-Nurse's Attitudes" (FINC-NA),
时间窗: one time at any point during the study: through study completion, an average of 1 year
The instrument consists of 26 items and four subscales: families as a resource in nursing care (10 items; score range 10 to 50), family as a conversational partner (8 items, score range 8 to 40), family as a burden ((four items, score range 4 to 20), and family as its own resource ((4 items, score range 4 to 20). Item scores are summed to create a total score that ranges from 26 to 130. After reverse coding negatively worded items from the Fam-B subscale, higher scores indicated more positive attitudes.
次要结局
未报告次要终点
研究者
Brigitte S. Cypress, EdD, RN, CCRN
ASSOCIATE PROFESSOR
Rutgers, The State University of New Jersey