Unplanned Admission to the ICU

Jennerich, Ann L.; Hobler, Mara R.; Sharma, Rashmi; Engelberg, Ruth A.; Curtis, J. Randall

doi:10.1016/j.chest.2020.05.554

Cited by 13 publications

(8 citation statements)

References 48 publications

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“…The ICULN is one way to support the family members both during and after ICU discharge. According to research in the area family members' anxiety and distress decreases if their needs for information and communication are met in a sincere and supportive way 9,54,55 . The ICULN support service is a good example of how a family‐centred support can be implemented.…”

Section: Discussionmentioning

confidence: 99%

Family member's experiences with and evaluation of an ICU Liaison Nurse Service: A qualitative study

Boerenbeker

Brandén

Chaboyer

et al. 2022

Nursing in Critical Care

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BackgroundFamily members of critically ill patients often experience anxiety when their relatives are transferred from ICU to another level of care. ICU liaison nurse (ICULN) visits have been associated with improved support for patients, their families and nursing staff but has not been extensively studied in the non‐English speaking setting. Yet, cross‐country variations such as how hospital care is delivered and by who means that innovations such as the ICULN may not be able to be simply transferred to other contexts and may not have similar outcomes.AimThe aim of this study was to investigate family member's experiences with and evaluation of ICULN support service in one Swedish ICU.Study DesignA qualitative evaluation study was undertaken, recruiting family members of former ICU patients. Audio‐taped in‐depth interviews were conducted. Data were analysed by content analysis.FindingsFifteen family members were interviewed. Two categories: Minds the gap between intensive care and the next care level and providing stability in an uncertain situation were identified. The ICULN supported the family members both directly, when the ICULNs listened to their questions and met their needs, and indirectly, when the ICULNs took responsibility for the patients and their physical and psychological conditions and wellbeing.ConclusionFamilies valued and were satisfied with the ICULN service but also gave suggestions to improve the service in this particular hospital context.Relevance to Clinical PracticeThe study showed that an ICULN support service met several needs of family members and therefore was a beneficial way to support patients and family members in the transition from the ICU to the ward.

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Section: Discussionmentioning

confidence: 99%

Family member's experiences with and evaluation of an ICU Liaison Nurse Service: A qualitative study

Boerenbeker

Brandén

Chaboyer

et al. 2022

Nursing in Critical Care

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“…Also, it is worth to consider the impact of unplanned ICU admission following surgery on patient's family. The unexpected ICU transfer has demonstrated a stressful event for patient's family members asking for timely and high-quality information about the patient's status throughout the whole process of ICU admission [27].…”

Section: Impact On Clinical Outcomementioning

confidence: 99%

Unexpected intensive care unit admission after surgery: impact on clinical outcome

Cammarota,

De Robertis,

Simonte

2024

Current Opinion in Anaesthesiology

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Purpose of review This review is focused on providing insights into unplanned admission to the intensive care unit (ICU) after surgery, including its causes, effects on clinical outcome, and potential strategies to mitigate the strain on healthcare systems. Recent findings Postoperative unplanned ICU admission results from a combination of several factors including patient's clinical status, the type of surgical procedure, the level of supportive care and clinical monitoring outside the ICU, and the unexpected occurrence of major perioperative and postoperative complications. The actual impact of unplanned admission to ICU after surgery on clinical outcome remains uncertain, given the conflicting results from several observational studies and recent randomized clinical trials. Nonetheless, unplanned ICU admission after surgery results a significant strain on hospital resources. Consequently, this issue should be addressed in hospital policy with the aim of implementing preoperative risk assessment and patient evaluation, effective communication, vigilant supervision, and the promotion of cooperative healthcare. Summary Unplanned ICU admission after surgery is a multifactorial phenomenon that imposes a significant burden on healthcare systems without a clear impact on clinical outcome. Thus, the early identification of patient necessitating ICU interventions is imperative.

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“… 22 Additionally, clinicians who take the time to acknowledge emotions are also ranked as more competent by their patients and on average only adds 21 seconds to the length of a visit. 23–25 …”

Section: The Hierarchy Of Communication Needs: a Biological Approach ...mentioning

confidence: 99%

The Hierarchy of Communication Needs: A Novel Communication Strategy for High Mistrust Settings Developed in a Brazilian COVID-ICU

Forte,

Stoltenberg,

Ribeiro

et al. 2024

Palliative Medicine Reports

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Context: The COVID-19 pandemic presented unique challenges for health care systems. Overcrowded units, extreme illness severity, uncertain prognoses, and mistrust in providers resulted in a “pressure cooker” where traditional communication strategies were often insufficient. Objectives: Building on well-studied traditional communication interventions, neurobiology principles were used to create a novel communication strategy designed in the COVID-ICU to respond to the unique communication needs of patients within the context of a high mistrust setting. Methods: The hierarchy of communication needs recognizes three specific levels of communication that are essential within high-emotion and low-trust settings. The first level is to establish trust. The second level is to resonate with patients' emotions, helping to reduce arousal and improve empathy. The third level includes the more traditional content of disclosing prognostic information and shared decision-making. When facing communication challenges, clinicians are taught to move back a level and reattune to emotions and/or reestablish trust. Discussion: The COVID pandemic revealed the shortcomings of a primarily cognitive communication style. The hierarchy of communication needs emphasizes trust building, and emotional resonance as prerequisites of effective cognitive discussions, resulting in more effective clinician–patient communication that more fully incorporates cultural humility and better meets the needs of diverse patient populations. Additional research is needed to further develop this strategy and evaluate its impact on patient experience and outcomes.

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Unplanned Admission to the ICU

Cited by 13 publications

References 48 publications

Family member's experiences with and evaluation of an ICU Liaison Nurse Service: A qualitative study

Family member's experiences with and evaluation of an ICU Liaison Nurse Service: A qualitative study

Unexpected intensive care unit admission after surgery: impact on clinical outcome

The Hierarchy of Communication Needs: A Novel Communication Strategy for High Mistrust Settings Developed in a Brazilian COVID-ICU

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