Blair K Taylor A, Eccleston Sarah D, Binder Hannah M, McCarthy Mary S
Critical Care Nursing Section, Department of Inpatient Services, Madigan Army Medical Center, Tacoma, WA, USA.
Center for Nursing Science & Clinical Inquiry, Department of Inpatient Services, Madigan Army Medical Center, Tacoma, WA, USA.
J Patient Exp. 2017 Mar;4(1):4-9. doi: 10.1177/2374373517692927. Epub 2017 Feb 9.
The critical care literature in the US has recently brought attention to the impact an ICU experience can have long after the patient survives critical illness, particularly if delirium was present. Current recommendations to mitigate post-intensive care syndrome (PICS) are embedded in patient and family-centered care and aim to promote family presence in the ICU, provide support for decision-making, and enhance communication with the health-care team. Evidence-based interventions are few in number but include use of an ICU diary to minimize the psychological and emotional sequelae affecting patients and family members in the months following the ICU stay. In this paper we describe our efforts to implement an ICU diary and solicit feedback on its role in fostering teamwork and communication between patients, family members, and ICU staff. Next steps will involve a PICS follow-up clinic where trained staff will coordinate specialty referrals and perform long-term monitoring of mental health and other quality of life outcomes.
美国的重症护理文献最近引起了人们对重症监护病房(ICU)经历在患者从危重病中存活很长时间后可能产生的影响的关注,尤其是在出现谵妄的情况下。目前减轻重症监护后综合征(PICS)的建议融入了以患者和家庭为中心的护理中,旨在促进家属在ICU的陪伴,为决策提供支持,并加强与医疗团队的沟通。基于证据的干预措施数量不多,但包括使用ICU日记,以尽量减少ICU住院后的几个月里影响患者和家属的心理和情绪后遗症。在本文中,我们描述了我们实施ICU日记的努力,并征求其在促进患者、家属和ICU工作人员之间的团队合作和沟通方面的作用的反馈。接下来的步骤将包括一个PICS随访诊所,训练有素的工作人员将协调专科转诊,并对心理健康和其他生活质量结果进行长期监测。