Kozub Elizabeth, Scheler Stephanie, Necoechea Gloria, OʼByrne Noeleen
Surgical Intensive Care Unit, Sharp Memorial Hospital, San Diego, California.
Crit Care Nurs Q. 2017 Apr/Jun;40(2):144-154. doi: 10.1097/CNQ.0000000000000151.
The focus on patient- and family-centered care (PFCC) has become increasingly prevalent throughout health care. In the intensive care unit (ICU), family involvement becomes critical, as patients are often unable to fully engage in their care. After expanding family visitation to 24 hours, nurses in a surgical ICU perceived that they did not have the ability to tailor the visitation to meet the patient's condition and there was an opportunity to improve nurse satisfaction related to PFCC. The objective of this performance improvement project was to increase nurse satisfaction related to PFCC and create consistency across clinicians for visitation practices. The Unit Practice Council developed staff guidelines for family visitation that included scripting prompts the nurse could use when communicating with families. The adoption of staff guidelines for family visitation was helpful in creating a culture change toward PFCC. Nurses' overall mean stress level with PFCC decreased, and their perception of having difficulty in reducing patients' or families' anxieties also decreased. The development of guidelines for family visitation can be easily implemented across other critical care environments. Scripting prompts along with the visitation guidelines can serve as a useful strategy to build nurses' skills in communicating with families.
以患者和家庭为中心的护理（PFCC）在整个医疗保健领域越来越普遍。在重症监护病房（ICU），由于患者通常无法充分参与自身护理，家庭参与变得至关重要。在将家属探视时间延长至24小时后，一家外科ICU的护士认为他们没有能力根据患者的病情调整探视安排，并且有机会提高与PFCC相关的护士满意度。这个绩效改进项目的目标是提高与PFCC相关的护士满意度，并在临床医生中实现探视实践的一致性。科室实践委员会制定了家属探视的员工指南，其中包括护士在与家属沟通时可以使用的脚本提示。采用家属探视的员工指南有助于营造一种向PFCC转变的文化。护士在PFCC方面的总体平均压力水平降低了，并且他们认为在减轻患者或家属焦虑方面存在困难的看法也减少了。家属探视指南的制定可以很容易地在其他重症监护环境中实施。脚本提示与探视指南一起可以作为一种有用的策略，以培养护士与家属沟通的技能。
