Au Selena S, Roze des Ordons Amanda L, Amir Ali Asma, Soo Andrea, Stelfox Henry T
Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada; Department of Oncology, Division of Palliative Care, University of Calgary, Calgary, Alberta, Canada.
J Crit Care. 2019 Dec;54:235-238. doi: 10.1016/j.jcrc.2019.08.031. Epub 2019 Aug 29.
We aimed to describe point of care communication encounters with patients' families in centers with open visitation practices.
Cross-sectional one-day point prevalence study in 14 Canadian adult intensive care units (ICUs) located in 7 academic and 7 community hospitals with open family visitation policies.
ICU bedside nurses working on a randomly selected weekday completed a survey reporting all observed communication between providers and patients' families. Family point of care communication encounters were measured for 146 of 159 patients (92%) admitted to the study ICUs. Most patients had family (98%) with the majority observed visiting on the study date (73%). Of patients with family (n = 143), direct in-person communication occurred 71% of the time, either via participation in rounds (23%), family meetings (24%), and/or informal updates (71%). 43% (n = 62) of families had direct communication with a physician or nurse practitioner. Nurses provided the largest portion of informal bedside updates (83%, n = 85) and supplemented family communication with phone calls (22%, n = 31). There was no communication contact for 13% (n = 19) of families.
ICUs adopt multiple ways of communicating with family members of critically ill patients. Significant interactions occur outside of traditional family meetings, in a less formal and more frequent fashion. Our study supports development of tools to support best practices within contemporary communication paradigms to support provider, patients and family needs.
我们旨在描述在实行开放探视制度的中心,医护人员与患者家属在床边进行沟通交流的情况。
在加拿大7家学术医院和7家社区医院的14个成人重症监护病房(ICU)进行了为期一天的横断面现况研究,这些医院均实行开放的家属探视政策。
在随机选择的工作日在ICU床边工作的护士完成了一项调查,报告了医护人员与患者家属之间所有观察到的沟通情况。对159名入住研究ICU的患者中的146名(92%)进行了家属床边沟通交流情况的测量。大多数患者有家属陪伴(98%),且大部分家属在研究当天前来探视(73%)。在有家属陪伴的患者中(n = 143),71%的时间存在直接的面对面沟通,方式包括参与查房(23%)、家庭会议(24%)和/或非正式的病情通报(71%)。43%(n = 62)的家属与医生或执业护士进行了直接沟通。护士进行了大部分非正式的床边病情通报(83%,n = 85),并通过电话补充家属沟通(22%,n = 31)。13%(n = 19)的家属没有沟通接触。
ICU采用多种方式与重症患者家属进行沟通。在传统家庭会议之外,以不太正式且更频繁的方式进行了大量互动。我们的研究支持开发工具,以在当代沟通模式中支持最佳实践,满足医护人员、患者和家属的需求。