Involving Users in the Development of Effective Critical Care Discharge Information: A Focus Group Study

Self Cite

Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. Overall evidence was of low quality but use of individualized information was associated with beneficial physical effects for patients and increased knowledge and satisfaction for their relatives. Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users’ needs are discussed. Results should inform the design of future studies on this topic.

Section: Meeting Individual Needsmentioning

confidence: 99%

Effectiveness of Critical Care Discharge Information in Supporting Early Recovery From Critical Illness

Bench

Day²,

Griffiths

2013

Self Cite

“…2 Delivery of information should be sensitive to the patient and families' current needs, recognizing that some patients report increased anxiety when information is shared before they are ready to receive it. 10 Evidence supports that delivery of patient information is most efficient and meaningful when it is presented in small quantities to decrease cognitive load, well timed in response to a patient's readiness to learn, and rich with the use of multimedia images. [14][15][16] Objective Despite the documented need for information among patients and families, ICU educational content is often not centrally located or organized to make it easily accessible to patients and families within an ICU.…”

mentioning

confidence: 99%

“…7,8 Family members of critically ill patients consistently identify the need for information and the need for reassurance as the highest priority needs during an ICU hospitalization, yet the need for information is often unmet. [9][10][11] Furthermore, the ICU is a unique setting where patients and family members are coping with stress, 12,13 and they need useful, real-time information adapted to the critically ill patient's anxiety. 2 Delivery of information should be sensitive to the patient and families' current needs, recognizing that some patients report increased anxiety when information is shared before they are ready to receive it.…”

mentioning

confidence: 99%

Identifying Information Resources for Patients in the Intensive Care Unit and Their Families

Schnock

Ravindran

Fladger

et al. 2017

BACKGROUND Providing information to patients in intensive care units and their families is challenging. Patients often are admitted unexpectedly and experience stress and uncertainty. One source of stress has been identified as unclear, uncoordinated, or inconsistent communication and information. Despite the need for information, no centrally located, easily accessible, standardized intensive care unit education content exists. OBJECTIVE To identify educational content for patients in the intensive care unit and their families across 4 different hospitals, develop a general content database, and organize the general content into a framework for education of patients and their families. METHODS Educational content for patients in the intensive care units of 4 participating hospitals was collected and a gap analysis was performed. RESULTS Key content format and categories were identified. Educational content was organized into an information pathway divided into 3 phases: intensive care unit arrival; understanding the intensive care unit and partnering in care; and intensive care unit transitions. The gap analysis revealed substantial variation in content format and categories. CONCLUSIONS Structuring a digital learning center using different stages of the patient’s stay in the intensive care unit and placing resources in the context of an information pathway can help coordinate education for these patients and their families, and creates a consistent communication guide for clinicians as well. The optimal digital format should be considered in designing the learning center.

“…46,47 They often thought that these decisions were made exclusively by other health care providers. 44,46,47 Interestingly, several studies 45,46,48 demonstrated that critical care clinicians were able to assess several elements effectively during critical illness that were vital to predicting selfcare abilities at discharge, including prior and current functional status and availability of caregiver assistance. Although critical care practitioners were able to assess some aspects of care needs effectively while patients were in critical care, further research is needed to develop and evaluate care coordination tools, including standardized handoff and outreach services that are effective, adaptable, and easily used by critical care nurses.…”

Section: Communication Interventions To Support Patients and Caregiversmentioning

confidence: 99%

“…4,7,24 In order to facilitate improved outcomes for critically ill patients, it is essential to initiate early, effective discharge planning and caregiver education within the critical care unit. Several qualitative studies 44,45 demonstrated that critical care nurses are often resistant to implementing discharge planning because of patients' acuity. Critical care nurses also cited time constraints as a limitation on their ability to initiate discharge planning effectively.…”

Section: Communication Interventions To Support Patients and Caregiversmentioning

confidence: 99%

Role of Transitional Care Measures in the Prevention of Readmission After Critical Illness

Peters

2017

Transitioning from the critical care unit to the medical-surgical care area is vital to patients’ recovery and resolution of critical illness. Such transitions are necessary to optimize use of available hospital resources to meet patient care needs. One in 10 patients discharged from the intensive care unit are readmitted to the unit during their hospitalization. Critical care readmission is associated with significant increases in illness acuity, overall length of stay, and health care costs as well as a potential 4-fold increased risk of mortality. Patients with complex illness, multiple comorbid conditions, and a prolonged initial stay in the critical care unit are at an increased risk of being readmitted to the critical care unit and experiencing poor outcomes. Implementing nurse-driven measures that support continuity of care and consistent communication practices such as critical care outreach services, transitional communication tools, discharge planning, and transitional care units improves transitions of patients from the critical care environment and reduces readmission rates.