Purpose of reviewAn appreciation of a family's difficult experience in dealing with their critically ill loved ones has created the concept of ‘family-centered care’. The purpose of this paper is to review the literature on the needs of the family during their intensive care unit experience.Recent f

The perspective of families of the critically ill patient: their needs.

/pdf/infection-prevention-and-control-of-epidemic-and-pandemic-3qj2cze3ny.pdf

Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care.: WHO Interim Guidelines

Aims and objectives.  This study aims to explore the kind and frequency of care provided to hospitalized cancer patients by relatives and the reasons for providing this care.



Background.  Informal care is a common phenomenon across many countries. In Greece, informal caring activities occur in most hospitals. Patients’ relatives stay by their bedside for long hours and assist with care. This phenomenon is highly correlated with the nursing staff shortage.



Method.  This study was carried out in a Greek oncology hospital. The sample consisted of 150 informal caregivers. We used a 37-item questionnaire called In-Hospital Informal Care Questionnaire Acute Care.



Results.  The participants provide substantial help to their patients daily. On average, they stay by their bedside for 20·23 hours in a 24-hour period. Additionally, 104 participants stated that they hire a privately paid patient's helper.



The relatives stay by their patients’ bedside for various reasons such as: (1) severity of the condition; (2) providing psychological support; (3) family tradition; (4) because they do not believe their patients are safe in the hospital without their supervision; or (5) the nursing staff shortage.



Conclusions.  The participants offer informal care that reflects specific nursing duties. We could argue that Greek hospitals ‘use’ relatives as unpaid labour to compensate for the nursing shortage. It is disquieting that usually someone from the hospital staff suggests to the relatives to stay at the patient's bedside even after visiting hours or to hire a private paid patient's helper. This implies that the staff considers such contribution necessary.



Relevance to clinical practice.  The findings show that relatives perform daily tasks that nurses should be performing. They indicate that the hospital should introduce specific staffing policies for reducing families’ burden. Our findings could influence future staffing plans of nursing managers, policy makers or health authorities.

Dimensions of informal care in Greece: the family's contribution to the care of patients hospitalized in an oncology hospital.

Leadership agenda for change toward healthy work environments in acute and critical care.

Objectives The objective of this study was to evaluate the effect of nontechnical skills (NTS) training on performance in advanced life support (ALS) simulation. Furthermore, we aimed to determine the ideal frequency of training sessions for an optimal retention and the value of debriefing. Methods A systematic search was performed using PubMed, EMBASE, WoS, ERIC, CINAHL, and the Cochrane Library conducted through August 1, 2018. All primary studies mentioning NTS in ALS education were included. Three reviewers independently extracted data on study design and outcome. The MERSQI approach was used to evaluate the overall quality of evidence. Results Of the 10,723 identified articles, 40 studies were included with a combined total of 3,041 participants, ranging from students to experts. Depending on the focus of the study, articles were categorized in NTS (n = 25), retention (n = 8), and feedback (n = 10). Incorporating NTS during ALS simulation showed significant improvements in timing for performing critical first steps. Furthermore, good leadership skills had a favorable effect on overall technical performance and teamwork during simulation improved team dynamics and performance. Finally, debriefing also had a beneficial effect on team performance. One particular type of debriefing does not appear to be superior to other types of debriefing. Conclusion Team simulation training resulted in improved NTS and a reduction in the time required to complete a simulated cardiac arrest. Therefore, a formal NTS program should be introduced into ALS courses. Feedback and repetitive practice are key factors to train NTS. The impact of training on team behaviors can persist for at least 3 to 6 months. In conclusion, understanding and improving NTS may help to create more effective teams. The effect on patient outcome requires further investigation.

The Effect of Teaching Nontechnical Skills in Advanced Life Support: A Systematic Review.

With the hospital-based transmission of Severe Acute Respiratory Syndrome (SARS) in Ontario, acute care hospitals severely restricted visitor access. Now that the SARS outbreak is under control, hospitals struggle with the balance between adhering to patient- and family-centred care models, and addressing the future threat of infectious diseases. To evaluate the effect of visitor restrictions and to guide future visitation policies, the Ottawa Hospital conducted a preliminary survey of patients, next of kin, staff, physicians and volunteers. Ninety percent of staff surveyed supported some form of visitor restrictions, while 71% indicated that they felt comfortable asking visitors to leave if they had exceeded current restrictions. The majority of patients (80%) and next of kin (76%) were at least moderately satisfied with current restricted limiting hours. A disproportionate number of positive comments on current visiting restrictions were received from both patients and staff. In the absence of evidence on which to base future visitor policy development, objective input from healthcare workers, patients and families is invaluable.

Restrictive Visitor Policies: Feedback from Healthcare Workers, Patients and Families

Patient safety has come a long way since the release of the 1999 Institute of Medicine report To Err Is Human. This report revealed the immense size of the problem of preventable adverse events - events that in the past we assumed were "just complications" occurring in the normal course of diagnosis and treatment. Simultaneously, shining the light on patient safety "took the lid off quality." Those of us involved in healthcare provision always had a commitment to providing high-quality care, yet the focus of many key stakeholders on the importance of high-quality healthcare had been limited. The focus tended to be disproportionately on the rising cost of healthcare rather than a balanced focus on quality. Now, we respect the imperative of achieving high-quality healthcare.

Patient Safety: We've Come a Long Way.

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Restrictive Visitor Policies: Feedback from Healthcare Workers, Patients and Families

Patient Safety: We've Come a Long Way.