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重症监护病房中与患者家属的沟通:一项现况调查研究。

Communication with patients' families in the intensive care unit: A point prevalence study.

作者信息

Au Selena S, Roze des Ordons Amanda L, Amir Ali Asma, Soo Andrea, Stelfox Henry T

机构信息

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.

出版信息

J Crit Care. 2019 Dec;54:235-238. doi: 10.1016/j.jcrc.2019.08.031. Epub 2019 Aug 29.

Abstract

PURPOSE

We aimed to describe point of care communication encounters with patients' families in centers with open visitation practices.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

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。

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