Objective:To determine whether patient- and family-centered care interventions in the ICU improve outcomes.Data Sources:We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library databases from inception until December 1, 2016.Study Selection:We included articles involving patient- and

Outcomes of Patient- and Family-Centered Care Interventions in the ICU: A Systematic Review and Meta-Analysis.

Objectives:To synthesize data on outcomes related to patients, family members, and ICU professionals by comparing flexible versus restrictive visiting policies in ICUs.Data Sources:Medline, Scopus, and Web of Science.Study Selection:Observational and randomized studies comparing flexible versus rest

Flexible Versus Restrictive Visiting Policies in ICUs: A Systematic Review and Meta-Analysis.

OBJECTIVE: To examine perceptions by intensive care unit (ICU) workers of unrestricted visitation, to measure visiting times, and to determine prevalence of symptoms of anxiety and depression in family members. DESIGN: Observational, prospective, single-center cohort. SETTING: Medical-surgical ICU in a 460-bed tertiary-care hospital. PATIENTS: Two hundred nine consecutive patients hospitalized >3 days were studied over the first 5 ICU days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Characteristics of patients (n = 209), families (n = 149), and ICU workers (n = 43) were collected. ICU workers reported their perceptions of unrestricted visitation, and family members completed the Hospital Anxiety and Depression Scale. Daily severity scores (Simplified Acute Physiology Score II and Logistic Organ Failure) and a workload score (Nine Equivalents of Nursing Manpower) were computed. Maximum median visit length was 120 mins per patient per day and occurred on days 4 and 5. No correlations were found among severity of illness, workload, and visit length. For 115 patients, both nurse and physician questionnaires were available; although several differences were noted, neither nurses nor physicians perceived open visitation as disrupting patient care. The median rating for delay in organizing care was "never" for physicians and "occasionally" for nurses. Nurses perceived more disorganization of care than physicians (p = .008). Compared with nurses, the physicians reported greater family trust (p = .0023), more family stress (p = .047), and greater unease when examining the patient (p = .02). The Hospital Anxiety and Depression Scale indicated symptoms of anxiety in 73 (49%) family members and depression in 44 (29.5%). CONCLUSIONS: The 24-hr visitation policy was perceived favorably by families. It induced only moderate discomfort among ICU workers, due to the potential for care interruption, in particular for nurses.

Perceptions of a 24-hour visiting policy in the intensive care unit.

Introduction : Patient satisfaction is an element of psychological health which influence the results of the medical care and their impact. Patient experience can be quantified from their questioning or direct observation. Objectives: The purpose of this paper is to analyze and evaluate the satisfaction of nursing activities closely related to the patients admitted in ICU ward Institute of Oncology Prof. Dr. Ion Chiricuţa Cluj-Napoca. Materials and Methods : This paper describes a prospective study conducted on a sample of 106 patients hospitalized in the intensive care unit of the Institute of Oncology Prof. Dr. Ion Chiricuţa Cluj-Napoca in June 2011 - August 2011. The results were obtained using descriptive and analytical statistical technique of SPSS software. To detect relationships / associations between qualitative variables the Chi-Square test was used (statistically significant association if p ≤ 0.05). Patients received an anonymous questionnaire applied at 24 hours after discharge from the IT department so that the responses would be most sincerely. Results: Patients selected only two degrees of satisfaction, 53.8% very satisfied , respectively 46.2% satisfied . Dissatisfaction factors that may affect satisfaction were communication, accommodation facilities, factors arising from the lack of personal, pain and lack of sleep. Conclusions : Satisfaction “score” is influenced by education level and diagnosis. Resumption of the questionnaire is required periodically to assess the results of our section. It is also necessary to continue to compare results with other departments in the country.

/pdf/evaluation-of-patient-satisfaction-4m7akobtyd.pdf

Evaluation of patient satisfaction.

During the first wave of the COVID-19 pandemic, restricted visitation policies were enacted at acute care facilities to reduce the spread of COVID-19 and conserve personal protective equipment. In this study, we aimed to describe the impact of restricted visitation policies on critically ill patients, families, critical care clinicians, and decision-makers; highlight the challenges faced in translating these policies into practice; and delineate strategies to mitigate their effects.A qualitative description design was used. We conducted semistructured interviews with critically ill adult patients and their family members, critical care clinicians, and decision-makers (i.e., policy makers or enforcers) affected by restricted visitation policies. We transcribed semistructured interviews verbatim and analyzed the transcripts using inductive thematic analysis.Three patients, eight family members, 30 clinicians (13 physicians, 17 nurses from 23 Canadian intensive care units [ICUs]), and three decision-makers participated in interviews. Thematic analysis was used to identify five themes: 1) acceptance of restricted visitation (e.g., accepting with concerns); 2) impact of restricted visitation (e.g., ethical challenges, moral distress, patients dying alone, intensified workload); 3) trust in the healthcare system during the pandemic (e.g., mistrust of clinical team); 4) modes of communication (e.g., communication using virtual platforms); and 5) impact of policy implementation on clinical practice (e.g., frequent changes and inconsistent implementation).Restricted visitation policies across ICUs during the COVID-19 pandemic negatively affected critically ill patients and their families, critical care clinicians, and decision-makers.RéSUMé: OBJECTIF: Au cours de la première vague de la pandémie de COVID-19, des politiques de visite restreintes ont été adoptées dans les établissements de soins aigus afin de réduire la propagation de la COVID-19 et d’économiser les équipements de protection individuelle. Dans cette étude, nous avons cherché à décrire l’impact des politiques de visite restreintes sur les patients gravement malades, les familles, les intensivistes et les décideurs, ainsi qu’à souligner les difficultés rencontrées dans la mise en pratique de ces politiques et à définir des stratégies pour en atténuer les effets. MéTHODE: Une méthodologie de description qualitative a été utilisée. Nous avons mené des entretiens semi-structurés avec des patients adultes gravement malades et les membres de leur famille, les intensivistes et les décideurs (c.-à-d. les stratèges ou les responsables de l’application de la loi) touchés par les politiques de visite restreintes. Nous avons transcrit textuellement les entretiens semi-structurés et analysé les transcriptions à l’aide d’une analyse thématique inductive. RéSULTATS: Trois patients, huit membres de leur famille, 30 cliniciens (13 médecins, 17 infirmières de 23 unités de soins intensifs canadiennes) et trois décideurs ont participé à ces entrevues. L’analyse thématique a été utilisée pour identifier cinq thèmes : 1) l’acceptation des visites restreintes (p. ex., accepter avec des préoccupations); 2) l’impact des visites restreintes (p. ex., défis éthiques, détresse morale, patients mourant seuls, charge de travail accrue); 3) la confiance dans le système de santé pendant la pandémie (p. ex., méfiance à l’égard de l’équipe clinique); 4) les modes de communication (p. ex., communication à l’aide de plateformes virtuelles); et 5) l’incidence de la mise en œuvre des politiques sur la pratique clinique (p. ex., changements fréquents et mise en œuvre incohérente). CONCLUSION: Les politiques de visite restreintes dans les unités de soins intensifs pendant la pandémie de COVID-19 ont eu un impact négatif sur les patients gravement malades et leurs familles, les intensivistes et les décideurs. 

/pdf/impact-of-restricted-visitation-policies-during-covid-19-on-9epn3uv7.pdf

Impact of restricted visitation policies during COVID-19 on critically ill adults, their families, critical care clinicians, and decision-makers: a qualitative interview study

A simple intervention to improve satisfaction in patients and relatives

The great scientific and technological breakthrough in the field of experimental sciences applied to medicine and health sciences is being responsible for the process of dehumanization. To understand the process and bring back a humanistic view to education seems to be necessary to rehumanizing medicine.

/pdf/the-icu-humanization-program-contributions-from-the-1et09ls8mq.pdf

The ICU Humanization Program: contributions from the psychologist team.

The `Critical Care Family Needs Inventory' (CCFNI) has been used to identify the needs of the relatives of critically ill patients in ICUs. Few studies have compared the needs of the relatives with the perception of the health care team.

/pdf/needs-of-families-of-critically-ill-patients-and-perception-13cgbpdah6.pdf

Needs of families of critically ill patients and perception of the health care team.

The evaluation of a health service is intimately linked to the definition and the social consent and implies in values and ideologies. Its settles down in conformity or adaptation to that user's expectations.

/pdf/patients-and-their-relatives-satisfaction-in-an-intensive-1h2i9g0dvb.pdf

Patients' and their relatives' satisfaction in an intensive care unit

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A simple intervention to improve satisfaction in patients and relatives

The ICU Humanization Program: contributions from the psychologist team.

Needs of families of critically ill patients and perception of the health care team.

Patients' and their relatives' satisfaction in an intensive care unit