School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, Devon, PL4 8AA, UK.
School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington, New Zealand.
Int J Qual Health Care. 2020 Nov 16;32(9):625-638. doi: 10.1093/intqhc/mzaa106.
Patient safety has developed as a strong marker for healthcare quality. Safety matters are important in the intensive care unit (ICU) where complex clinical decisions are made, intensive technology is used, and families hold a unique role. The aim of this review was to identify and describe factors that influence family member's perceptions of safety in the adult ICU.
Searches were conducted between September and November 2018 and repeated in July 2020 using CINAHL, MEDLINE (EBSCO), PubMed and PsycINFO databases.
Published primary studies undertaken in adult ICUs and involving adult family member participants exploring safety or feeling safe. No date restrictions were applied.
A data extraction form collected information about sample, study design, data collection methods and results from each paper. Methodological quality was assessed using the QualSyst tools for qualitative and quantitative studies. Narrative synthesis was undertaken.
Twenty papers were included with 11 papers published since 2010. The majority of papers reported on qualitative studies (n = 16). Four factors were identified that influenced whether family members felt that the patient was safe in ICU: family visiting, information and communication, caring and professional competence.
In detailing specific practices that make families feel safe and unsafe in ICU, these review findings provide a structure for clinicians, educators and researchers to inform future work and gives opportunity for the family role in patient safety to be reconsidered.
患者安全已成为医疗质量的重要标志。在做出复杂临床决策、使用强化技术以及家属发挥独特作用的重症监护病房（ICU）中，安全问题至关重要。本综述的目的是确定和描述影响成年 ICU 中家庭成员对安全感知的因素。
2018 年 9 月至 11 月和 2020 年 7 月，使用 CINAHL、MEDLINE（EBSCO）、PubMed 和 PsycINFO 数据库进行了检索。
发表于成人 ICU 并涉及成年家属参与者的探索安全性或感觉安全的前瞻性或回顾性研究。未对发表日期进行限制。
数据提取表从每篇论文中收集了有关样本、研究设计、数据收集方法和结果的信息。使用 QualSyst 工具对定性和定量研究进行了方法学质量评估。进行了叙述性综合。
共纳入 20 篇论文，其中 11 篇发表于 2010 年以后。大多数论文报告了定性研究（n = 16）。确定了四个影响家庭成员对 ICU 患者安全感知的因素：家属探视、信息和沟通、护理和专业能力。
通过详细描述使家庭成员在 ICU 感到安全和不安全的具体做法，本综述结果为临床医生、教育者和研究人员提供了一个框架，以告知未来的工作，并为重新考虑家庭在患者安全中的作用提供了机会。
