Positive Effects of a Nursing Intervention on Family-Centered Care in Adult Critical Care
- Marion Mitchell, B Nursing (Hons), GCert Higher Education, PhD,
- Wendy Chaboyer, B Science, M Nursing, PhD,
- Elizabeth Burmeister, BN, MS (biostatistics) and
- Michelle Foster, BN, MN (Critical Care)
- Marion Mitchell is the deputy head of the School of Nursing and Midwifery, Logan Campus, Research Centre Clinical and Community Practice Innovation, Griffith University, Meadowbrook, Queensland, Australia, and Wendy Chaboyer is the director of Research Centre Clinical and Community Practice Innovation. Elizabeth Burmeister is in the nursing practice and development unit at Princess Alexandra Hospital, Woolloongabba, Queensland, Australia, and Michelle Foster is a nurse manager in the intensive care unit at Gold Coast Hospital, Southport, Queensland, Australia.
- Corresponding author:
Dr Marion Mitchell, School of Nursing and Midwifery, Logan Campus, Research Centre Clinical and Community Practice Innovation, Griffith University, Meadowbrook, Queensland, Australia 4131 (e-mail: Marion.mitchell{at}griffith.edu.au).
Abstract
Background Generally, families of critical care patients are not actively involved in the patients’ care in meaningful ways. A family-centered care model formalizes each patient and the patient’s family as the unit of care. Family-centered care comprises 3 concepts: respect, collaboration, and support.
Objective To evaluate the effects on family-centered care of having critical care nurses partner with patients’ families to provide fundamental care to patients.
Methods At the control site, patients’ families experienced usual care; at the intervention site, patients’ families were invited to assist with some of their relative’s fundamental care with nurses’ support. The family-centered care survey was used to measure families’ perceptions of respect, collaboration, support, and overall family care at baseline and 48 hours later. Multivariate logistic regression was used to determine independent predictors of scores.
Results A total of 174 family members of patients participated (75 control, 99 intervention). Total median scores on the survey were 3.2 (control) and 3.2 (intervention) at baseline and 3.2 (control) and 3.5 (intervention) at follow-up. After adjustments in the multivariate model, the family-centered care intervention was the strongest predictor of scores at 48 hours (odds ratio [OR]=1.66; P<.001). Other independent predictors included relatives with previous critical care experience (OR=1.27; P=.006) and those who were partners of the patient (OR=1.33; P=.002).
Conclusion Partnering with patients’ family members to provide fundamental care to the patients significantly improved the respect, collaboration, support, and overall scores on the family-centered care survey at 48 hours.
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Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
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Identify a family-centered care model and the 3 key indicators that comprise such a model.
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Describe ways in which a critical care nurse can partner with patients’ families to provide fundamental care to patients.
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Discuss the effects of family involvement in providing care to intensive care unit patients on their perceptions of respect, support, and collaboration.
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Footnotes
- ©2009 American Association of Critical-Care Nurses
