CARDIOTHORACIC INTENSIVE CARE UNIT

Cardiothoracic Intensive Care Unit

Table of Content

INTRODUCTION3

Purpose of this Paper5

REVIEW OF LITERATURE5

Identifying Family Needs5

Nursing Perceptions of Family Needs12

Problem16

METHODOLOGY16

Instruments17

Sample18

Patients18

RESULTS19

DISCUSSION22

LIMITATIONS24

CONCLUSION25

REFERENCES26

APPENDIX26

Cardiothoracic Intensive Care Unit

Introduction

Recent initiatives encourage a family presence during cardiopulmonary resuscitation and invasive procedures and more open visitation policies in intensive care units (ICUs). This study investigated perceptions of needs of those visiting and working in six ICUs. The needs of family members visiting patients with critical illness and nurses working in ICUs were measured using the Critical Care Family Needs Inventory. Data were collected prospectively using a convenience sample of 101 patients, family members, and nurses. Hierarchical cluster analysis identified the themes of (a) emotional resources and support, (b) trust and facilitation of needs, (c) treatment information, and (d) feelings. Family members and nurses differed significantly on three of the four themes (p = .000).

This is important information for neuroscience nurses and other healthcare professionals to consider in providing care, setting visiting policies in ICUs, and developing approaches such as family-centered care. It is a very stressful time for a family when one of its members is hospitalized in an intensive care unit (ICU); some even define this as a time of crisis for families. The response by healthcare professionals is varied in types of visitation policies and the level of family involvement advocated.

The Institute of Medicine (2001) strongly recommended that healthcare delivery systems become more patient centered, which in ICUs translates into increased family involvement Many organizations, including the American Association of Critical-Care Nurses and the Emergency Nurses Association, issued statements that family members of patients undergoing cardiopulmonary resuscitation should be given the option of being present during cardiopulmonary resuscitation and other invasive procedures (American Association of Critical-Care Nurses, 2004; Emergency Nurses Association, 2001). The Institute for Healthcare Improvement advocated the liberalizing of visiting hours in ICUs (Berwick & Kotagal, 2004). The American College of Critical Care Medicine Task Force issued clinical practice guidelines for support of the family in the patient-centered ICU. Two pertinent recommendations were the following: (a) Open visitation in the adult ICU should be structured to allow flexibility for patients and families and be determined on a case-by-case basis, and (b) the patient, family, and nurse should determine the visitation schedule, collectively taking into account the best interest of the patient (Davidson et al., 2007). It is clearly important for neuroscience nurses and all healthcare professionals to have an understanding of the needs of family members to provide support in the most appropriate manner in ICUs.

Purpose of this Paper

The purposes of this article were to provide a review of the literature and report the findings of a study that identified family members' and nurses' perceptions of needs of individuals visiting and nurses caring for patients in six ICUs. This was considered an important first step before redesigning visiting policies at our institution in light of recommendations for patient-centered ICUs.

Review of Literature

The basic needs of families have been summarized as (a) information, (b) reassurance, (c) support, and (d) ability to be near the patient (Damboise & ...