Alhussaini Anhar
Safety, Quality, Informatics and Leadership, Harvard Medical School, Boston, USA.
Health Professions, Johns Hopkins University, Baltimore, USA.
Cureus. 2021 Dec 30;13(12):e20837. doi: 10.7759/cureus.20837. eCollection 2021 Dec.
Communicating uncertainty with patients and families in the intensive care unit is challenging and requires time and skill to convey the information. This proposal aims to provide a structured path for identifying and communicating uncertainty with patients and families in the unit. The focus is to improve the quality of care and timely communication to meet the expectations and needs of families and patients. The project focuses on the first 24 hours of intensive care unit admission to improve communication of uncertainty. By utilizing the Plan-Do-Study-Act cycle, the workflow uses a screening tool to identify uncertainty and communicate using evidence-based recommendations and the mnemonic VALUE (Value family statements, Acknowledge emotions, Listen, Understand the patient as a person, Elicit questions) as the standard of care. The workflow can be incorporated during the routine rounds as part of the A-F liberation bundle. The outcome is to improve patient and family satisfaction scores using a validated Family Satisfaction with Care in the Intensive Care Unit (FS-ICU 24) questionnaire to achieve a score of 75 or more, which correlates with very good. Challenges and limitations are discussed in the proposal.
在重症监护病房与患者及其家属沟通不确定性是一项具有挑战性的任务，需要时间和技巧来传达信息。本提案旨在提供一条结构化的途径，用于识别并与病房中的患者及其家属沟通不确定性。重点是提高护理质量和及时沟通，以满足家属和患者的期望与需求。该项目聚焦于重症监护病房入院后的头24小时，以改善不确定性的沟通。通过运用计划-执行-研究-行动循环，工作流程使用一种筛查工具来识别不确定性，并依据循证建议以及助记符VALUE（重视家属陈述、承认情绪、倾听、将患者视为人来理解、引出问题）作为护理标准进行沟通。该工作流程可在日常查房期间作为A-F解放套餐的一部分加以整合。结果是使用经过验证的《重症监护病房护理家属满意度》（FS-ICU 24）问卷来提高患者和家属的满意度得分，以达到75分或更高，这与“非常好”相关。提案中讨论了挑战和局限性。
