Humanizing the intensive care unit

Wilson, Michael E.; Beesley, Sarah J.; Grow, Amanda; Rubin, Eileen; Hopkins, Ramona O.; Hajizadeh, Negin

doi:10.1186/s13054-019-2327-7

Cited by 59 publications

(48 citation statements)

References 10 publications

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“…Los profesionales que atienden a los pacientes en aislamiento de contacto por su patología infecciosa, lo atenderán con las medidas de protección indicadas todas las veces que sea precisa su atención, explicándoles la justificación de restricción de visitas y atendiendo sus necesidades y cuidados necesarios. Se favorecerá el acompañamiento familiar, cuando la situación epidemiológica lo permita y en las condiciones de aislamiento protector que esté recomendado (12,13). Ambos agentes alargan el QTc en distinto grado e interfieren en las vías metabólicas de eliminación, por lo que se debe vigilar la aparición de posibles efectos sinérgicos sobre el alargamiento del QTc.…”

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Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)

et al. 2020

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Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)

et al. 2020

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“…Individual freedom may be limited by situations in which one cannot express oneself, cannot pursue one's individual goals, or cannot access opportunities to act [41]. There is also a perception in the literature of patients' experiences regarding lack or bad communication, lack of information, lack of control, helplessness, anxiety, pain, ventilation, dependency, insomnia and delirium that carry a risk of overriding the autonomy and dignity of the individual [42,43].…”

Section: Discussionmentioning

confidence: 99%

Adult Patients’ Experience of Coercion in Intensive Care: A Scoping Review

Jöbges¹,

Mouton-Dorey²,

Ricou³

et al. 2021

Preprint

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Background The use of coercion, which can be understood in a clinical context as imposing a measure against a patient’s opposition or declared will, can occur in various forms in intensive care units (ICU). One prime example of a coercive measure in the ICU is the use of restraints, which are applied for patients` own safety and for the protection of caregivers. A scoping review was conducted to explore the empirical data available on the experiences of ICU patients with coercive measures.Main text For this scoping review, clinical databases (PubMED, EMBASE, PsychINFO, Web of Science Core Collection, CINAHL, Scopus and Cochrane Library) were searched for qualitative studies. Using the CASP criteria for qualitative studies, the review focused on empirical research that captured how ICU patients themselves experienced restraints or other forms of coercion and excluded research related to staff experiences. A total of nine studies could be retrieved that fulfilled the inclusion criteria.The review describes common themes emerging from the scarce studies on patient experiences, including communication issues, delirium, memory, and emotional reactions. In spite of their serious clinical condition and fluctuating states of consciousness, a part of the patients did have memories of their ICU stay. Statements from patients revealed feelings of compromised autonomy and dignity that came with a loss of control. Physical restraints were only one concrete manifestation of coercion as perceived by patients in the ICU setting. Conclusion To date, there are few qualitative studies focusing on patient experiences of coercive measures in the ICU. In addition to the experience of restricted physical movement, the perception of loss of control, loss of dignity and loss of autonomy suggests that restraining measures are just one element in a setting that may be perceived as coercive. Health professionals may underestimate how deeply patients are affected by the perception of coercion. Good communication that clearly explains unavoidable measures to patients can reduce the negative impacts of coercive measures. More research on patient experiences is needed in order to reach a more comprehensive understanding of how patients perceive their ICU stay and to identify opportunities for further improvement of intensive care.

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“…A zentensivist manner opens the door to bonding with patients and other caregivers, thereby restoring humanity to the ICU ( 20 ). It is manifested by honesty, humility, and patient advocacy, effectively allowing the patient and family to be heard.…”

Section: Calming Presencementioning

confidence: 99%

The Zentensivist Manifesto. Defining the Art of Critical Care

et al. 2020

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Evidence-based medicine asks us to integrate the best available evidence with clinical experience and patient values. In the modern intensive care unit, the primary focus is on complex technology and electronic health records, often away from the bedside. Excess interventionism is the norm. The term “intensivist” itself implies an intensive management strategy, which can lead us away from a patient-centered practice and toward iatrogenic harm. Under the hashtag #zentensivist, an international, multiprofessional group of clinicians has begun to discuss via Twitter how to apply key principles of history taking, physical examination, physiology, pharmacology, and clinical research in a competent, compassionate, and minimalist fashion. The term “zentensivist” intentionally combines concepts seemingly at odds—Zen philosophy and intensive care—to describe a holistic approach to the art of caring for the critically ill. We describe the key tenets of zentensivist practice and how we may inspire these actions in those we lead and educate.

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Humanizing the intensive care unit

Cited by 59 publications

References 10 publications

Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)

Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)

Adult Patients’ Experience of Coercion in Intensive Care: A Scoping Review

The Zentensivist Manifesto. Defining the Art of Critical Care

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