Building trust through communication in the intensive care unit: HICCC*

DeLemos, Destinee; Chen, Minna; Romer, Amy; Brydon, Kyla; Kastner, Kathleen; Anthony, Benjamin P.; Hoehn, K. Sarah

doi:10.1097/pcc.0b013e3181b8088b

Cited by 33 publications

(62 citation statements)

References 22 publications

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“…Parents seek honest, clear, and complete information 42,44–50 to be able to actively participate in decision- making 47,51 and in the physical care and comfort to their child, 43,44,47 as well as to cope with uncertainty and fear of a poor outcome.. 42,49,52 Access to information can make parents feel more prepared, less helpless, and give them a sense of control. 42,44,49,52 Parents reported that they wanted to receive information even when it was potentially distressing 42,43,53 and wanted to be informed about decisions even when clinicians are the primary decision-makers.…”

Section: Synthesis Of Findingsmentioning

confidence: 99%

Elements of Family-Centered Care in the Pediatric Intensive Care Unit

Richards

Starks

O’Connor

et al. 2017

J Hosp Palliat Nurs

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This paper reports result from a systematic search and thematic analysis of qualitative literature to identify key issues related to family-centered care, behaviors, and communication skills that support the parental role and improve patient and family outcomes in the PICU. Five themes were identified: 1) sharing information; 2) hearing parental voices; 3) making decisions for or with parents; 4) negotiating roles; and 5) individualizing communication. These themes highlight several gaps between how parents want to be involved and perceive clinicians engage them in the care of their child. Parental preferences for involvement differ in the domains of information sharing, decision making, and power-sharing across a spectrum of parental roles from parents as care provider to care recipient. The PICU setting may place clinicians in a double bind trying to both engage families and protect them from distress. Asking families of critically ill children about their preferences for participation across these domains may improve clinician-family relationships.

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Section: Synthesis Of Findingsmentioning

confidence: 99%

Elements of Family-Centered Care in the Pediatric Intensive Care Unit

Richards

Starks

O’Connor

et al. 2017

J Hosp Palliat Nurs

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“…8,16 They serve as educators by interpreting medical information and facilitating communication between physicians and family. 17 The purpose of this study is to describe PICU nurses’ perceptions of the benefits and challenges of providing FCC, given the policy and practice changes needed to facilitate FCC in PICUs.…”

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confidence: 99%

Nurses’ Reflections on Benefits and Challenges of Implementing Family-Centered Care in Pediatric Intensive Care Units

et al. 2018

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Background Family-centered care is a proposed way of supporting family involvement with a child’s care and decreasing distress associated with a child’s critical illness by improving communication, helping manage stress and coping, and decreasing conflicts. Nurses are critical to successful implementation of family-centered care. Objectives To describe nurses’ perceptions of the benefits and challenges of providing family-centered care in pediatric intensive care units. Methods Semistructured interviews of 10 bedside and charge nurses in pediatric, cardiac, and neonatal intensive care units. Questions were related to 4 domains: the intensive care unit environment and its relationship to the structure and delivery of critical care, stressors for nurses and families, communication challenges and strategies, and involvement of families in care and decision-making. Results The main thematic finding was the nurses’ descriptions of a “balancing act” to provide quality family-centered care. The balancing act was characterized by the interaction between 2 types of changes: (1) intensive care unit policies related to visitation hours and family presence at the bedside and (2) physical transformations in the intensive care unit from shared open space to individual private rooms. Conclusions All of the nurses viewed the transition to family-centered care as having benefits for families. They also described how changes had created new challenges for the delivery of nursing care in intensive care units, particularly regarding mentorship and the safety of patients and staff.

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“…Despite this lack of a prior relationship between the intensive care physician and the family member, decisions that represent a refocusing of care goals were made during or shortly following these conferences, highlighting the importance of establishing trust during these meetings. Delemos et al (28) demonstrated that families of children in the PICU valued trust in PICU physicians and reported that communication was vital to building that trust. Physician-family communication in medical care outside of the ICU depends heavily on prior relationships and continuity of care (29,30).…”

Section: Discussionmentioning

confidence: 98%