Livingston Daniel S, Krishnan Vidya
Division of Pulmonary and Critical Care Medicine and.
Division of Physician Informatics, Community Physician Network, Kokomo, Indiana.
ATS Sch. 2023 Jul 20;4(3):332-343. doi: 10.34197/ats-scholar.2022-0142OC. eCollection 2023 Sep.
Critical illness is a stressful time for patients and their support networks. Although patient-directed educational material to improve the understanding of critical illness exists, both patients and staff members are often unaware of these resources or how to find them.
We aimed to evaluate the impact of the implementation of the American Thoracic Society's (ATS) "Managing the Intensive Care Unity (ICU) Experience: A Proactive Guide for Patients and Families", an ICU orientation pamphlet, on nurses' perceptions of the availability and effectiveness of patient and family educational resources.
In a safety-net urban institution, we surveyed medical ICU (MICU) nurses in February 2021 regarding their perceptions of the availability of patient and family educational materials and the time and quality of communication with families of critically ill patients. We then introduced the MICU nurses to the ATS ICU orientation pamphlet to complement patient and family education. Quick response (QR) codes were created, linking to the online versions of the ICU pamphlet, and made available in waiting rooms. Printed copies of the pamphlet were provided to families in the ICU introductory packet upon patient MICU admission. We informed nurses regarding the pamphlet content, website, and QR codes. A postintervention survey was administered 11 months after the initial survey. Changes between pre and postintervention responses were analyzed for significant differences. Debriefing sessions with the MICU nurses were conducted, and subsequent discussions identified opportunities to improve the available educational resources.
At baseline, 28 of 67 (42%) MICU nurses responded to the survey. Although all nurses provided verbal education to patients and families, only 18% reported knowing about and using additional resources to supplement this education. The postintervention survey was completed by 39% of nurses; 39% of them reported using additional materials to supplement patient and family education. Reported awareness of the ATS ICU pamphlet increased from 4% before implementation to 23% after implementation ( = 0.04). MICU nurses offered suggestions to improve the pamphlet, which thematically fell into three categories: ) opportunities to alter the ICU pamphlet, ) opportunities to provide the pamphlet in varied formats, and ) opportunities to add additional education topics.
Informing nurses about the ICU pamphlet improved the acceptance and use of the materials, but it was still not accepted by many nurses. Barriers to ICU nurses using patient education resources should be explored to facilitate quality materials reaching patients and complementing patient communication. QR codes may have offered a way to disseminate educational materials to patients and families in a manner not previously considered. The process of evaluating the ICU pamphlet for our institution led to a broader discussion of additional needs for patient and family educational materials for our patient population. We encourage institutions to evaluate the sufficiency of their patient and family educational materials for similar local benefits.
危重病对患者及其支持网络来说是一段压力巨大的时期。尽管存在旨在提高对危重病理解的患者导向型教育材料,但患者和工作人员往往都不了解这些资源或不知道如何找到它们。
我们旨在评估美国胸科学会(ATS)的《管理重症监护病房(ICU)体验:患者及家属主动指南》(一本ICU介绍手册)的实施对护士对患者及家属教育资源的可获取性和有效性认知的影响。
在一家城市安全网机构中,我们于2021年2月对医学重症监护病房(MICU)护士进行了调查,了解他们对患者及家属教育材料可获取性的看法,以及与危重病患者家属沟通的时间和质量。然后,我们向MICU护士介绍了ATS的ICU介绍手册,以补充患者及家属教育。创建了快速响应(QR)码,链接到ICU手册的在线版本,并在候诊室提供。在患者入住MICU时,将手册的印刷版提供给ICU介绍资料包中的家属。我们告知护士手册的内容、网站和QR码。在初次调查11个月后进行了干预后调查。分析干预前后回复的变化以找出显著差异。与MICU护士进行了汇报会,并在随后的讨论中确定了改进现有教育资源的机会。
基线时,67名MICU护士中有28名(42%)回复了调查。尽管所有护士都对患者和家属进行了口头教育,但只有18%的护士报告了解并使用其他资源来补充这种教育。39%的护士完成了干预后调查;其中39%的护士报告使用了其他材料来补充患者及家属教育。报告对ATS的ICU手册的知晓率从实施前的4%提高到了实施后的23%(=0.04)。MICU护士提出了改进手册的建议,主题上分为三类:)修改ICU手册的机会,)以多种格式提供手册的机会,以及)添加其他教育主题的机会。
告知护士有关ICU手册的信息提高了材料的接受度和使用率,但仍有许多护士未接受。应探索ICU护士使用患者教育资源的障碍,以促进优质材料能送达患者并补充患者沟通。QR码可能提供了一种以前未考虑过的向患者和家属传播教育材料的方式。为我们机构评估ICU手册的过程引发了对我们患者群体的患者及家属教育材料其他需求的更广泛讨论。我们鼓励各机构评估其患者及家属教育材料的充分性,以获得类似的本地益处。