Models of Peer Support to Remediate Post-Intensive Care Syndrome: A Report Developed by the Society of Critical Care Medicine Thrive International Peer Support Collaborative*

McPeake, Joanne; Hirshberg, Eliotte L.; Christie, LeeAnn M.; Drumright, Kelly; Haines, Kimberley; Hough, Catherine L.; Meyer, Joel; Wade, Dorothy; Andrews, Adair; Bakhru, Rita N.; Bates, Samantha; Barwise, John; Bastarache, Julie A.; Beesley, Sarah J.; Boehm, Leanne M.; Brown, Sheryl; Clay, Alison S.; Firshman, Penelope; Greenberg, Steven B.; Harris, Wendy; Hill, C.; Hodgson, Carol; Holdsworth, Clare; Hope, Aluko A.; Hopkins, Ramona O.; Howell, David C.; Janssen, Anna; Jackson, James C.; Johnson, Annie; Kross, Erin K.; Lamas, Daniela; MacLeod-Smith, Belinda; Mandel, Ruth; Marshall, John C.; Mikkelsen, Mark E.; Nackino, Megan; Quasim, Tara; Sevin, Carla M.; Slack, Andrew; Spurr, Rachel; Still, Mary; Thompson, Carol; Weinhouse, Gerald L.; Wilcox, M. Elizabeth; Iwashyna, Theodore J.

doi:10.1097/ccm.0000000000003497

Cited by 93 publications

(46 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Within the THRIVE Collaborative, six general models of peer support are utilised and represented within this study: Community based models; Psychologist-led outpatient models; Models based within ICU follow-up clinics; Online models; Group-based models based within ICU and peer mentor models [2]. All programs involved in the THRIVE Post-ICU Clinic collaborative utilized a multi-disciplinary team approach.…”

Section: Methodsmentioning

confidence: 99%

“…Recognition of adverse post-intensive care unit (ICU) outcomes has prompted clinicians to extend their practice beyond the physical location of the ICU [1–4]. In some settings, this post-ICU care takes the form of ICU follow-up clinics [1, 3, 5] or peer support programs [2, 6]. Such post-ICU programs have been coordinated by the Society of Critical Care Medicine’s (SCCM) THRIVE initiative [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objective To identify the key mechanisms that clinicians perceive improve care in the intensive care unit (ICU), as a result of their involvement in post-ICU programs. Methods Qualitative inquiry via focus groups and interviews with members of the Society of Critical Care Medicine’s THRIVE collaborative sites (follow-up clinics and peer support). Framework analysis was used to synthesize and interpret the data. Results Five key mechanisms were identified as drivers of improvement back into the ICU: (1) identifying otherwise unseen targets for ICU quality improvement or education programs—new ideas for quality improvement were generated and greater attention paid to detail in clinical care. (2) Creating a new role for survivors in the ICU—former patients and family members adopted an advocacy or peer volunteer role. (3) Inviting critical care providers to the post-ICU program to educate, sensitize, and motivate them—clinician peers and trainees were invited to attend as a helpful learning strategy to gain insights into post-ICU care requirements. (4) Changing clinician’s own understanding of patient experience—there appeared to be a direct individual benefit from working in post-ICU programs. (5) Improving morale and meaningfulness of ICU work—this was achieved by closing the feedback loop to ICU clinicians regarding patient and family outcomes. Conclusions The follow-up of patients and families in post-ICU care settings is perceived to improve care within the ICU via five key mechanisms. Further research is required in this novel area. Electronic supplementary material The online version of this article (10.1007/s00134-019-05647-5) contains supplementary material, which is available to authorized users.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…ICU survivors face a wide range of challenges (Cuthbertson et al, 2010;Haines et al, 2015;Herridge et al, 2011;McPeake et al, 2019) as they recover from their critical illness. These global challenges are termed post-intensive care syndrome (PICS): a new or worsening impairment in mental, cognitive, or physical health after critical illness.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Recognition of adverse post-ICU outcomes have prompted critical care providers to extend care beyond the ICU (Lasiter et al, 2016;McPeake et al, 2019;Sevin et al, 2018;Williams & Leslie, 2008).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Patients’ experiences of recovery: Beyond the intensive care unit and into the community

Calkins

Kako

Guttormson

2020

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aims To understand barriers and facilitators of recovery for critical illness survivors’, who are discharged home from the hospital and do not have access to dedicated outpatient care. Design Multi‐site descriptive study guided by interpretive phenomenology using semi‐structured interviews. Methods Interviews were conducted between December 2017 ‐July 2018. Eighteen participants were included. Data were collected from interview recordings, transcripts, field notes, and a retrospective chart review for sample demographics. Analysis was completed using Interpretive Phenomenological Analysis which provided a unique view of recovery through the survivors’ personal experiences and perception of those experiences. Results Participants encountered several barriers to their recovery; however, they were resilient and initiated ways to overcome these barriers and assist with their recovery. Facilitators of recovery experienced by survivors included seeking support from family and friends, lifestyle adaptations, and creative management of their multiple medical needs. Barriers included unmet needs experienced by survivors such as mental health issues, coordination of care, and spiritual needs. These unmet needs left participants feeling unsupported from healthcare providers during their recovery. Conclusion This study highlights important barriers and facilitators experienced by critical illness survivors during recovery that need be addressed by healthcare providers. New ways to support critical illness survivors, that can reach a broader population, must be developed and evaluated to support survivors during their recovery in the community. Impact This study addressed ICU survivors’ barriers and facilitators to recovery. Participants encountered several barriers to recovery at home, such as physical, cognitive, psychosocial, financial, and transportation barriers, however, these survivors were also resilient and resourceful in the development of strategies to try to manage their recovery at home. These results will help healthcare providers develop interventions to better support ICU survivors in the community.

show abstract

“…(2,3) PICS can also impact on the family members of ICU survivors. (4,5) A cardinal symptom of PICS is fatigue, (6) which is defined as an overwhelming, sustained sense of exhaustion, typically unrelieved by sleep, with decreased capacity for physical and mental work at a usual level. (7,8)…”

Section: Introductionmentioning

confidence: 99%

Prevalence and experience of fatigue in survivors of critical illness: A mixed-methods systematic review

Bench

Stayt

Shah

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective To investigate the prevalence, experience and management of fatigue in adult survivors of critical illness. Data sources An electronic search was performed on seven databases: CINAHL, Medline, EMBASE, PsycINFO, Emcare, British Nursing Index, and Web of Science. Study selection and data extraction Seventy-six peer-reviewed, English language studies that investigated fatigue or vitality in adult patients admitted to an Intensive Care Unit (ICU) and followed up for any period were included. Extracted data were split into three datasets for analysis: data from vitality domain of SF-36 (dataset A), other quantitative data (dataset B), and qualitative data (dataset C). Methodological quality was assessed using the critical appraisal skills programme (CASP) tools. Data synthesis We adopted a segregated approach to mixed-methods synthesis. We merged all datasets, attributing all results to one of four qualitative themes. These were prevalence and severity, contributing factors, impacts on quality of life, assessment and management. Results The prevalence of fatigue ranged from 13.8 to 80.9 %. Fatigue severity reached its nadir at approximately one month post ICU discharge, improved over time but seldom reached reference population scores. Various biological, disease related and psychological factors associated with fatigue were identified including age, poor pre-morbid status and sleep disturbance. No critical illness specific tool to assess fatigue in ICU survivors was identified. A paucity of evidence based interventions for management of fatigue in ICU survivors were identified despite fatigue negatively impacting on survivors quality of life. Conclusions This mixed method review shows that fatigue is highly prevalent in ICU survivors, negatively impacting their recovery. To date, no ICU specific fatigue assessment tool or targeted intervention has been designed to manage this symptom. Our review has identified factors, which may increase or mitigate against fatigue, along with potential management strategies, which should be used to inform future research and practice.

show abstract

Models of Peer Support to Remediate Post-Intensive Care Syndrome: A Report Developed by the Society of Critical Care Medicine Thrive International Peer Support Collaborative*

Cited by 93 publications

References 40 publications

Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

Patients’ experiences of recovery: Beyond the intensive care unit and into the community

Prevalence and experience of fatigue in survivors of critical illness: A mixed-methods systematic review

Contact Info

Product

Resources

About