Involving Relatives in ICU Patient Care: The Barriers and Enablers. McConnell, Bridget Anne. Downloaded 3-May :53:15

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1 The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based nursing materials. Take credit for all your work, not just books and journal articles. To learn more, visit Item type Title Authors Presentation Involving Relatives in ICU Patient Care: The Barriers and Enablers McConnell, Bridget Anne Downloaded 3-May :53:15 Link to item

2 Involving relatives in ICU patient care: The barriers and enablers Bridget McConnell- RN, BN (Hons) Tracey Moroney-RN, BN (Hons), PhD, Grad Cert Ed Studies (Higher Ed) MACN Sydney, Australia

3 Learning Objectives To articulate reasons for relative inclusion and exclusion Identify personal strengths and weaknesses in regards to relative involvement in patient care

4 Why study this topic? (Intensive Care Hotline, 2014)

5 Current literature Relatives ICU experiences (Verhaeghe et al. 2005, McKiernan & McCarthy 2010, Cypress 2011, Eriksson et al. 2011) Relatives needs (Verhaeghe et al. 2005, El-Masri & Fox-Wasylyshyn 2007, Blanchard & Alavi 2008, Al-Mutair et al. 2013) The critical care nurse- relative relationship (Stayt 2007, Agård & Maindal 2009, Mitchell & Chaboyer 2010) ICU visiting policies (Farrell et al. 2005, Hunter et al. 2010, Agård & Lomborg 2011, Soury-Lavergne et al. 2011) The benefits of relative involvement (Williams 2005, Blanchard & Alavi 2008, Mitchell et al. 2009, Wåhlin et al. 2009, Hunter et al. 2010, Mitchell & Chaboyer 2010, Agård & Lomborg 2011, Cypress 2011, Al-Mutair et al. 2013)

6 Research questions 1. In the critical care environment, what are the barriers and/or enablers to nurses involving relatives in patient care? 2. If barriers and/or enablers are found, why do they exist?

7 Methodology and Methods MIXED METHODS Quantitative Online questionnaire Linking Phase 1 to Phase 2 Qualitative Interviews

8 Results Phase one 60.0% 50.0% I involve family members in patient care. 54.3% 40.0% 30.0% 20.0% 18.6% 17.1% 10.0% 5.7% 4.3% 0.0% Never Rarely Some of the time Most of the time Always

9 Results Phase two 1. The challenges of involvement 2. Insecurity 3. Care director 4. Hospital policies and liability 5. Benefits of involvement 6. Patient privacy 7. Decision making 8. The fragile relative

10 Discussion The recognition of two nurses 1. The Gatekeeper (barriers) 2. The Facilitator (enablers)

11 The Gatekeeper Role Time Policies Gatekeeper Patient Privacy Adverse Events Insecurity

12 The Facilitator Resource Veracity Benefits Facilitator Long termers Experience Competency

13 Future recommendations Further research into the barriers and enablers Education ICU policies and guidelines Multidisciplinary team Caregiver specialist

14 Final conclusions Improve relative satisfaction in the often frightening intensive care environment Knowledge of barriers and enablers is likely to assist in the practice of involving relatives in ICU patient care

15 References Agård AS & Lomborg K (2011) Flexible family visitation in the intensive care unit: Nurses' decision-making. Journal of Clinical Nursing, 20, Agård AS & Maindal HT (2009) Interacting with relatives in intensive care unit. Nurses' perceptions of a challenging task. Nursing in Critical Care, 14, Al-Mutair AS, Plummer V, O Brien A & Clerehan R (2013) Family needs and involvement in the intensive care unit: A literature review. Journal of Clinical Nursing, 22, Blanchard D & Alavi C (2008) Asymmetry in the intensive care unit: Redressing imbalance and meeting the needs of family. Nursing in Critical Care, 13, Cypress BS (2011) The lived experience of nurses, patients and family members: A phenomenological study with Merleau-Pontian perspective. Intensive and Critical Care Nursing, 27, El-Masri MM & Fox-Wasylyshyn SM (2007). Nurses roles with families: Perceptions of ICU nurses. Intensive and Critical Care Nursing, 23, Eriksson T, Bergbom I & Lindahl B (2011) The experiences of patients and their families of visiting whilst in an intensive care unit- A hermeneutic interview study. Intensive and Critical Care Nursing, 27, Farrell ME, Joseph DH & Schwartz-Barcott D (2005) Visiting hours in the ICU: Finding the balance among patient, visitor and staff needs. Nursing Forum, 40, Hunter JD, Goddard C, Rothwell M, Ketharaju S & Cooper H (2010). A survey of intensive care unit visiting policies in the United Kingdom. Journal of the Association of Anaesthetics of Great Britain and Ireland, 65, Intensive Care Hotline. (2014). [Image of ICU patient]. Retrieved from

16 References McConnell, B. (2013). Involving relatives in ICU patient care: The barriers and enablers, (Honours thesis). University of Notre Dame, Australia, Sydney, N.S.W. McKiernan M & McCarthy G (2010) Family members lived experience in the intensive care unit: A phemenological study. Intensive and Critical Care Nursing, 26, Mitchell M, Chaboyer W, Burmeister E & Foster M (2009) Positive effects of a nursing intervention on family-centred care in adult critical care. American Journal of Critical Care, 18, Mitchell M.L & Chaboyer W (2010) Family centred care- A way to connect patients, families and nurses in critical care: A qualitative study using telephone interviews. Intensive and Critical Care Nursing, 26, Soury-Lavergne A, Hauchard I, Dray S, Baillot M, Bertholet E, Clabault K, Jeune S, Ledroit C, Lelias I, Lombardo V, Maetens Y, Meziani F, Reignier J, Souweine B, Tabah A, Barrau K & Roch A (2011) Survey of caregiver opinions on the practicalities of family-centred care in intensive care units. Journal of Clinical Nursing, 21, Stayt LC (2007) Nurses experiences of caring for families with relatives in intensive care units. Journal of Advanced Nursing, 57, Verhaeghe S, Defloor T, Van Zuuren F, Duijnstee M & Grypdonck M (2005) The needs and experiences of family members of adult patients in an intensive care unit: A review of the literature. Journal of Clinical Nursing, 14, Wåhlin I, Elk A & Idvall E (2009) Empowerment from the perspective of next of kin in intensive care. Journal of Clinical Nursing, 18, Williams CMA (2005) The identification of family members contribution to patients care in the intensive care unit: A naturalistic inquiry. Nursing in Critical Care, 10, 6-14.