在神经科学重症监护病房实施由护士主导的家庭会议。
Implementation of a Nurse-Led Family Meeting in a Neuroscience Intensive Care Unit.
作者信息
Wu Huixin, Ren Dianxu, Zinsmeister Glenn R, Zewe Gretchen E, Tuite Patricia K
机构信息
Huixin Wu, DNP, RN, CCRN, CCNS, is assistant professor, Department of Nursing, Chatham University, Pittsburgh, Pennsylvania. She also works as a clinical research coordinator in a Magnet designated hospital. She has over 20 years of critical care nursing experience. Her teaching experience includes instructing undergraduate and graduate nursing students. Dianxu Ren, PhD, MD, is associate professor and associate director for statistical support, University of Pittsburgh, Pennsylvania. His area of research is biostatistics including longitudinal data analysis, measurement error and missing data problems, Bayesian analysis and statistical computation. He has 9 years of experience at the University of Pittsburgh School of Nursing. Glenn R. Zinsmeister, MSN, RN, is clinical director of Neuroscience ICU, Surgical ICU, and a Neuro step down unit, UPMC Shadyside Hospital, Pittsburgh, Pennsylvania. He also serves as an Adjunct Clinical instructor at Carlow University, Pittsburgh, Pennsylvania. He has 30 years of nursing experience. Gretchen E. Zewe, PhD, RN, is assistant professor, University of Pittsburgh, Pennsylvania. Her primary teaching responsibility focuses on the senior medical-surgical course and senior seminar. She also serves on doctoral committees for both PhD and DNP students. Her clinical expertise is in the field of neurology. Patricia K. Tuite, PhD, RN, CCNS, is assistant professor and coordinator of the clinical nurse specialist area of concentration, University of Pittsburgh, Pennsylvania. She is currently the coordinator for the Medical-Surgical Clinical Nurse Specialist Area of Concentration. She teaches at the undergraduate and graduate levels.
出版信息
Dimens Crit Care Nurs. 2016 Sep-Oct;35(5):268-76. doi: 10.1097/DCC.0000000000000199.
PURPOSE/OBJECTIVES: The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members.
BACKGROUND
Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses.
METHODS
This quality improvement project was implemented in a 10-bed neuroscience ICU over a 3-month period. A convenience sample of 23 nurses participated in the project. Following development of a communication protocol to facilitate nurse-led meetings, the nurses received education and then implemented the protocol. Thirty-one family members participated in the project. Family members were surveyed before and after the meetings.
RESULTS
Mean meeting time was 26 (SD, 14) minutes. Following implementation of the meetings, findings demonstrated that families felt that communication improved (P = .02 and P = .008), they had appropriate information for decision making allowing them to feel in control (P = .002), and there was an increase in family satisfaction (P = .001).
CONCLUSION
Early ICU nurse-led family meetings were feasible, improved communication between ICU nurses and family members, facilitated decision making in ICU families, and increased satisfaction of family members.
目的/目标：本研究的目的是开展、实施并评估由重症监护病房（ICU）护士主导的早期家庭会议对护士与家属沟通、家属决策以及家属满意度的影响。
背景
ICU护士处于满足家属需求的理想位置，如果护士能持续提供真实信息，家属可能会更好地应对ICU住院带来的危机；然而，目前尚无由床边护士主导的早期ICU家庭会议。
方法
本质量改进项目在一个拥有10张床位的神经科学ICU中进行，为期3个月。23名护士通过便利抽样参与了该项目。在制定了促进护士主导会议的沟通协议后，护士们接受了培训，然后实施该协议。31名家属参与了该项目。在会议前后对家属进行了调查。
结果
平均会议时长为26（标准差，14）分钟。会议实施后，结果表明家属感觉沟通得到改善（P = 0.02和P = 0.008），他们获得了用于决策的适当信息，从而感到能够掌控局面（P = 0.002），并且家属满意度有所提高（P = 0.001）。
结论
早期由ICU护士主导的家庭会议是可行的，改善了ICU护士与家属之间的沟通，促进了ICU患者家属的决策，并提高了家属满意度。
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