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将家庭成员纳入查房以改善重症监护中的沟通。

Including Family Members in Rounds to Improve Communication in Intensive Care.

机构信息

Texas Health Harris Methodist Hospital, Fort Worth (Mss Simon and Gioe); Neurocritical Care Hospitalist, Neurocritical Care Associates of Fort Worth, Texas (Dr Sankara); INOVA Health System, Alexandria, Virginia (Ms Gioe); and Texas Health Resources, Arlington (Dr Newcomb).

出版信息

J Nurs Care Qual. 2021;36(1):25-31. doi: 10.1097/NCQ.0000000000000483.

Abstract

BACKGROUND

Family members frequently function as surrogate decision-makers in critical care settings. This role requires family to establish satisfactory communication with clinicians.

LOCAL PROBLEM

Posthospital patient satisfaction with communication scores were lower than desired. Investigators assumed family member satisfaction with communication could influence patient satisfaction scores.

METHODS/INTERVENTIONS: Including family members in multidisciplinary daily clinical rounds was implemented in a 22-bed neurointensive care unit (ICU). Family members who attended rounds were compared with those who did not. Changes in clinician time devoted to rounding were measured.

RESULTS

The intervention increased time devoted to clinical rounds by 4 minutes per patient on average. Rounding dose correlated positively while depression correlated negatively with family satisfaction with communication. No harm, such as family member agitation, anxiety, or complaints, was found.

CONCLUSIONS

Including family in rounding in the ICU appears safe and can improve family satisfaction with communication, but whether it influences patient satisfaction remains an open question.

摘要

背景

在重症监护环境中,家庭成员经常担任替代决策人。这一角色要求家属与临床医生进行满意的沟通。

当地问题

住院后患者对沟通的满意度评分低于预期。调查人员假设家属对沟通的满意度会影响患者的满意度评分。

方法/干预措施:在一个 22 张床位的神经重症监护病房(NICU)中,让家庭成员参与多学科日常临床查房。将参加查房的家属与未参加查房的家属进行比较。测量了临床查房时间分配给临床医生的变化。

结果

该干预措施使每位患者的临床查房时间平均增加了 4 分钟。查房次数与家庭对沟通的满意度呈正相关,而抑郁程度与家庭对沟通的满意度呈负相关。未发现任何不良事件,如家属激动、焦虑或投诉。

结论

在 ICU 中让家庭成员参与查房似乎是安全的,可以提高家庭对沟通的满意度,但它是否会影响患者的满意度仍是一个悬而未决的问题。

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