Families’ Perception of the Value of Timed Daily “Family Rounds” in a Trauma ICU

Abstract

Daily communications between the ICU trauma patients’ families and the trauma team are often limited due to the unpredictable nature of subsequent patient admissions and operative procedures. In order to improve the lines of family-physician communication and educate residents regarding family communication, our level I trauma center instituted daily “Family Rounds” (FR). FR occur at the same time every day, in the patient's ICU room. The purpose of this study was to determine whether families valued the scheduled daily FR, to establish whether FR improved the family-physician relationship, and to delineate strengths and weaknesses of the present structure of our FR. We mailed surveys to family members of trauma patients hospitalized in the trauma ICU for ≥3 days. A total of 55 (22%) families responded. Combining “excellent” and “good” responses, 86.5 per cent of families looked forward to having a specific time of day to meet with the trauma team, and 90 per cent liked having rounds in the ICU room with the patient. However, 36 per cent did not like having only scheduled time for FR. The majority, 75 per cent, believed that all concerns were addressed during FR, and 84.9 per cent rated their overall experience as either excellent or good. Scheduled FR appear to improve communication between trauma surgeons and patients’ families, enhance the family-physician relationship, and strengthen our surgical residency teaching program.

Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU

“…The majority of literature examining family presence on rounds is descriptive or observational in nature and focuses on the needs, perceptions and preferences of family members and healthcare providers. Studies have been conducted in the adult (46)(47)(48), pediatric (49,50) or neonatal (51,52) ICUs. In general, family members are as satisfied or slightly more satisfied when they participate in rounds and tend to be more in favor of family participation than support the traditional rounds format that excludes family members.…”

An Integrated Framework for Effective and Efficient Communication with Families in the Adult Intensive Care Unit

“…There are different versions of family-centered rounds described in the literature, but they share several core elements: families are invited to be at the bedside when multidisciplinary team rounds are conducted; they are provided a brief lay summary of the patient's condition and allowed to listen in as the patient is discussed; and they are permitted a brief opportunity to ask questions. Family-centered rounds were first described in the pediatric setting (25,37,38), and then in the adult trauma ICU setting (24,39), and have expanded to other general and specialty adult ICU settings (26,27)…”

“…For example, individuals experiencing high levels of anxiety or conflict are often motivated to make decisions to decrease their level of arousal (17). Platforms for Clinician-Family Communication (24,25).…”

Implementing the SCCM Family-Centered Care Guidelines in Critical Care Nursing Practice

“…However, there is low-level evidence demonstrating that family members who participate in family-centered rounds report greater understanding and involvement in decision-making and satisfaction with clinical team communication than those who do not. [23][24][25] Family presence on rounds can also support and improve family member decision making. 26,27 As family involvement in interdisciplinary rounds is recommended in the Guidelines, nurses can continue to facilitate A final area explored in this section and one that garners strong professional opinion is family member attendance during resuscitation.…”