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Hoffmann M, Jeitziner MM, Riedl R, Mueller G, Peer A, Bachlechner A, Heindl P, Burgsteiner H, Schefold JC, von Lewinski D, Eller P, Pieber T, Sendlhofer G, Amrein K. Effects of an online information tool on post-traumatic stress disorder in relatives of intensive care unit patients: a multicenter double-blind, randomized, placebo-controlled trial (ICU-Families-Study). Intensive Care Med 2023; 49:1317-1326. [PMID: 37870597 PMCID: PMC10622355 DOI: 10.1007/s00134-023-07215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/27/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE Intensive care unit (ICU) hospitalization is challenging for the family members of the patients. Most family members report some level of anxiety and depression, sometimes even resulting in post-traumatic stress disorder (PTSD). An association has been reported between lack of information and PTSD. This study had three aims: to quantify the psychological burden of family members of critically ill patients, to explore whether a website with specific information could reduce PTSD symptoms, and to ascertain whether a website with information about intensive care would be used. METHOD A multicenter double-blind, randomized, placebo-controlled trial was carried out in Austria and Switzerland. RESULTS In total, 89 members of families of critically ill patients (mean age 47.3 ± 12.9 years, female n = 59, 66.3%) were included in the study. 46 relatives were allocated to the intervention website and 43 to the control website. Baseline Impact of Event Scale (IES) score was 27.5 ± 12.7. Overall, 50% showed clinically relevant PTSD symptoms at baseline. Mean IES score for the primary endpoint (~ 30 days after inclusion, T1) was 24 ± 15.8 (intervention 23.9 ± 17.9 vs. control 24.1 ± 13.5, p = 0.892). Hospital Anxiety and Depression Scale (HADS - Deutsch (D)) score at T1 was 12.2 ± 6.1 (min. 3, max. 31) and did not differ between groups. Use of the website differed between the groups (intervention min. 1, max. 14 vs. min. 1, max. 3; total 1386 "clicks" on the website, intervention 1021 vs. control 365). Recruitment was prematurely stopped in February 2020 due to coronavirus disease 2019 (COVID-19). CONCLUSION Family members of critically ill patients often have significant PTSD symptoms and online information on critical illness did not result in reduced PTSD symptoms.
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Affiliation(s)
- Magdalena Hoffmann
- Research Unit for Safety and Sustainability in Healthcare, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Executive Department for Quality and Risk Management, University Hospital of Graz, Graz, Austria
| | - Marie-Madlen Jeitziner
- Department of Intensive Care Medicine, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
- Department of Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Basel, Switzerland.
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Gerhard Mueller
- Department of Nursing Science and Gerontology, Institute of Nursing Science, UMIT TIROL - Private University of Health Sciences and Health Technology, Hall in Tyrol, Austria
| | - Andreas Peer
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | | | - Patrik Heindl
- Department of Intensive Care, Vienna General Hospital, Vienna, Austria
| | - Harald Burgsteiner
- Institute for Digital Media Education, University College of Teacher Education Styria, Graz, Austria
| | - Joerg C Schefold
- Department of Intensive Care Medicine, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | | | - Philipp Eller
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Pieber
- Research Unit for Safety and Sustainability in Healthcare, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Gerald Sendlhofer
- Research Unit for Safety and Sustainability in Healthcare, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- Executive Department for Quality and Risk Management, University Hospital of Graz, Graz, Austria
| | - Karin Amrein
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Huang YL, Chen YK, Lin SH, Cao H, Chen Q. The effect of short music videos on needs satisfaction and separation anxiety of children's family members during COVID-19: The example of TikTok. Front Pediatr 2022; 10:990752. [PMID: 36160769 PMCID: PMC9491336 DOI: 10.3389/fped.2022.990752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the effect of short music videos on needs satisfaction and separation anxiety of the family members of children with congenital heart disease (CHD) in the cardiac intensive care unit (CICU) during the COVID-19 pandemic. METHODS Eighty-seven children's family members were divided into the study group and the control group between February 2020 and March 2021. During the COVID-19 pandemic, the participants in the control group were visited by telephone, while the participants in the study group used the TikTok short music video application and WeChat as communication tools. After the intervention, the critical care family needs inventory (CCFNI) and separation anxiety scale (SAS) for all participants were recorded and analyzed. RESULTS There were no statistically significant differences in general characteristics or preintervention data between the two groups. However, the two dimensions of the support scale and information scale of the CCFNI in the study group were significantly different from those in the control group after the intervention (P = 0.008, and P = 0.021, respectively). There were significant differences in the three dimensions of the SAS between the two groups (P = 0.004, P = 0.007, and P = 0.041, respectively). CONCLUSION The visiting system of the ICU changed during the COVID-19 pandemic, and the use of the TikTok short music video application and WeChat was conducive to optimizing the CICU ward visiting process, reducing the separation anxiety of the family members of children in the CICU, and improving their needs satisfaction.
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Affiliation(s)
- Ya-Li Huang
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China.,College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Yu-Kun Chen
- College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Shi-Hao Lin
- College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China.,College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Department of Cardiac Surgery, Fujian Children's Hospital, Fuzhou, China.,College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
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Padilla Fortunatti C, Munro CL. Factors associated with family satisfaction in the adult intensive care unit: A literature review. Aust Crit Care 2021; 35:604-611. [PMID: 34535370 DOI: 10.1016/j.aucc.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The objective of this study was to identify and summarise factors associated with family satisfaction among family members of adult intensive care unit (ICU) patients. REVIEW METHODS/DATA SOURCES A search was conducted from inception to October 2020 in the following databases: PubMed, Scopus, EMBASE, CINAHL Plus, ProQuest Health Management, PsycINFO, LILACS, and SciELO. Studies reporting the questionnaire's items or dimensions as family satisfaction factors, studies dichotomising family satisfaction outcome, and those involving family members of neonatal, paediatric, palliative, and end-of-life patients were excluded. Quality of the studies was examined through a modified approach to the Consolidated Standards for Reporting Trials (CONSORT). Reported factors were classified as family member, patient, or provider/organisation related. RESULTS The search yielded 26 articles reporting factors associated with family satisfaction in the ICU. Regarding study quality, 19.2% were classified as high-quality studies. Family member-related variables such as educational level, gender, and kinship to the patient showed divergent associations with family satisfaction. Within patient-related variables, the severity of illness was positively associated with family satisfaction. Factors related to healthcare providers and organisations were reported only in 26.9% of the studies. CONCLUSIONS A broad number of factors associated with family satisfaction in the ICU were found in this review. However, few nonmodifiable factors related to the family members and the patient showed a significant and consistent association with family satisfaction. Evidence on factors related to healthcare providers was scarce. Gaps in knowledge regarding family satisfaction in the ICU, including methodological issues that impair the validity of the findings, were identified. Future studies should address these limitations to accurately identify factors that impact family satisfaction in the ICU.
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Affiliation(s)
- Cristóbal Padilla Fortunatti
- University of Miami, School of Nursing and Health Studies, Coral Gables, USA; Pontificia Universidad Católica de Chile, School of Nursing, Santiago, Chile.
| | - Cindy L Munro
- University of Miami, School of Nursing and Health Studies, Coral Gables, USA
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Abdul Halain A, Tang LY, Chong MC, Ibrahim NA, Abdullah KL. Psychological distress among the family members of Intensive Care Unit (ICU) patients: A scoping review. J Clin Nurs 2021; 31:497-507. [PMID: 34254377 DOI: 10.1111/jocn.15962] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To map research-based psychological distress among the family members with patients in the intensive care unit (ICU). BACKGROUND Having a loved one in the ICU is a stressful experience, which may cause psychological distress for family members. Depression, anxiety and stress are the common forms of psychological distress associated with ICU patient's family members. Directly or indirectly, psychological distress may have behavioural or physiological impacts on the family members and ICU patient's recovery. DESIGN The study was based on the five-stage methodological framework by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) and were guided by the PRISMA-ScR Checklist. METHODS A comprehensive and systematic search was performed in five electronic databases, namely the Scopus, Web of Sciences, CINAHL® Complete @EBSCOhost, ScienceDirect and MEDLINE. Reference lists from the screened full-text articles were reviewed. RESULTS From a total of 1252 literature screened, 22 studies published between 2010-2019 were included in the review. From those articles, four key themes were identified: (a) Prevalence of psychological distress; (b) Factors affecting family members; (c) Symptoms of psychological distress; and (d) Impact of psychological distress. CONCLUSIONS Family members with a critically ill patient in ICU show high levels of anxiety, depression and stress. They had moderate to major symptoms of psychological distress that negatively impacted both the patient and family members. RELEVANCE TO CLINICAL PRACTICE The review contributed further insights on psychological distress among ICU patient's family members and proposed psychological interventions that could positively impact the family well-being and improve the patients' recovery.
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Affiliation(s)
- Azura Abdul Halain
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Li Yoong Tang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Noor Airini Ibrahim
- Department of Anaesthesiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing School of Medical and Life Science, Sunway University, Selangor, Malaysia
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Halm MA. When Stakes Are High and Stress Soars: Addressing Health Literacy in the Critical Care Environment. Am J Crit Care 2021; 30:326-330. [PMID: 34195777 DOI: 10.4037/ajcc2021933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Margo A. Halm
- Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon
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Guáqueta Parada SR, Henao-Castaño ÁM, Motta Robayo CL, Triana Restrepo MC, Burgos Herrera JD, Neira Fernández KD, Peña Almanza BA. Intervenciones de Enfermería ante la Necesidad de Información de la Familia del Paciente Crítico. REVISTA CUIDARTE 2021. [DOI: 10.15649/cuidarte.1775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Durante el ingreso y permanencia del paciente en la unidad de cuidado intensivo, es imperativo considerar la satisfacción de las necesidades comunicacionales e informativas de la familia del paciente. Objetivo: Integrar los resultados de investigación sobre las intervenciones llevadas a cabo para satisfacer la necesidad de información de las familias de los pacientes en la unidad de cuidado intensivo. Materiales y Métodos: Se realizó una revisión integrativa de estudios en bases de datos Sciencedirect, PubMed, Biblioteca Virtual en Salud y Scielo, con la estrategia de búsqueda [Critical care] and [Needs assessment] and [Family] con criterios de inclusión de estudios publicados entre el año 2009 y el 2019 en idioma inglés, español y portugués disponibles en texto completo Resultados: Después de la lectura analítica de 41 estudios seleccionados se organizaron en 5 temas; uso de folletos de información, sesiones educativas, llamadas telefónicas, uso de tecnologías de la información y comunicación y reuniones familiares. Conclusión: Las intervenciones de enfermería que se han utilizado en la satisfacción de la necesidad de información de la familia son muy variadas e incluyen entre otras los folletos o el uso de TICs, sin embargo la intervención que responde en mayor medida a esta necesidad son las reuniones formales con la familia. Las intervenciones reportadas en los resultados de investigación para responder a la necesidad de información son herramientas clave para que el personal de enfermería las utilice según los recursos con los cuales dispone en su entorno laboral como salas de información para la familia.
Como citar este artículo: Guáqueta Parada Sandra Rocio, Henao Castaño Ángela María, Motta Robayo Claudia Lorena, Triana Restrepo Martha Cecilia, Burgos Herrera Juan David, Neira Fernández Karen Daniela, Peña Almanza Berni Alonso. Intervenciones de Enfermería ante la Necesidad de Información de la Familia del Paciente Crítico. Revista Cuidarte. 2021;12(2):e1775. http://dx.doi.org/10.15649/cuidarte.1775
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Caillet A, Coste C, Sanchez R, Allaouchiche B. [Involving families in intensive care]. SOINS; LA REVUE DE RÉFÉRENCE INFIRMIÈRE 2020; 65:17-21. [PMID: 33160461 DOI: 10.1016/s0038-0814(20)30139-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The place of families in intensive care is still too often underestimated. However, the involvement of family members would have multiple benefits for patients, but also for those around them. Family participation is a promising concept that needs to be studied on the ground and on a large scale, in order to prove itself and guide health professionals in their daily practice.
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Affiliation(s)
- Anaëlle Caillet
- Service de réanimation polyvalente, centre hospitalier Lyon-Sud, Hospices civils de Lyon, 165 chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - Charlotte Coste
- Service de réanimation polyvalente, centre hospitalier Lyon-Sud, Hospices civils de Lyon, 165 chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - Rocio Sanchez
- Service de réanimation polyvalente, centre hospitalier Lyon-Sud, Hospices civils de Lyon, 165 chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - Bernard Allaouchiche
- Service de réanimation polyvalente, centre hospitalier Lyon-Sud, Hospices civils de Lyon, 165 chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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8
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Hajalizadeh A, Ahmadinejad M, Dehghan M, Arab M. Informational Needs of the Families of Patients Discharged From Intensive Care Units: A Case of Iran. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 41:379-386. [PMID: 33143560 DOI: 10.1177/0272684x20972641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND thousands of patients are admitted to intensive care units annually, which is a stressful event. Many of these patients still require particular care after discharge. In many countries, families play an essential role in taking care of these patients after discharge. This study aimed to determine the informational needs of families of patients discharged from Intensive Care Units (ICU), Kerman, southeast Iran. METHODS this study had a cross-sectional design. Families were selected using the information extracted from patients' medical records. One hundred forty family members of the ICU discharged patients participated in the survey using convenience sampling. Data collection tools were a validated researcher-made questionnaire about informational needs and a demographic characteristics form. RESULTS the mean score of family informational needs was 31.18 ± 3.97 out of 40. Most families required a high level of information in all dimensions. However, the maximum need was associated with self-care subscale (4.89 out of 5), and the minimum need was associated with defecation (3.13 out of 5). CONCLUSION the families of patients discharged from intensive care units required much information about different areas of care particularly self-care. Health care providers, especially nurses, should be aware of the informational needs of the ICU patients' families post-discharge to provide better care.
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Affiliation(s)
- Asma Hajalizadeh
- Nursing and Midwifery School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Ahmadinejad
- Anesthesiology and Critical Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Critical Care Department, Nursing and Midwifery School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansoor Arab
- Nursing and Midwifery School, Bam University of Medical Sciences, Bam
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Cherak SJ, Rosgen BK, Amarbayan M, Plotnikoff K, Wollny K, Stelfox HT, Fiest KM. Impact of social media interventions and tools among informal caregivers of critically ill patients after patient admission to the intensive care unit: A scoping review. PLoS One 2020; 15:e0238803. [PMID: 32915848 PMCID: PMC7485758 DOI: 10.1371/journal.pone.0238803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022] Open
Abstract
Background The use of social media in healthcare continues to evolve. The purpose of this scoping review was to summarize existing research on the impact of social media interventions and tools among informal caregivers of critically ill patients after patient admission to the intensive care unit (ICU). Methods This review followed established scoping review methods, including an extensive a priori-defined search strategy implemented in the MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane CENTRAL Register of Controlled Trials databases to July 10, 2020. Primary research studies reporting on the use of social media by informal caregivers for critically ill patients were included. Results We identified 400 unique citations and thirty-one studies met the inclusion criteria. Nine were interventional trials–four randomized controlled trials (RCTs)–and a majority (n = 14) were conducted (i.e., data collected) between 2013 to 2015. Communication platforms (e.g., Text Messaging, Web Camera) were the most commonly used social media tool (n = 17), followed by social networking sites (e.g., Facebook, Instagram) (n = 6), and content communities (e.g., YouTube, SlideShare) (n = 5). Nine studies’ primary objective was caregiver satisfaction, followed by self-care (n = 6), and health literacy (n = 5). Nearly every study reported an outcome on usage feasibility (e.g., user attitudes, preferences, demographics) (n = 30), and twenty-three studies reported an outcome related to patient and caregiver satisfaction. Among the studies that assessed statistical significance (n = 18), 12 reported statistically significant positive effects of social media use. Overall, 16 of the 31 studies reported positive conclusions (e.g., increased knowledge, satisfaction, involvement) regarding the use of social media among informal caregivers for critically ill patients. Conclusions Social media has potential benefits for caregivers of the critically ill. More robust and clinically relevant studies are required to identify effective social media strategies used among caregivers for the critically ill.
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Affiliation(s)
- Stephana J. Cherak
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Brianna K. Rosgen
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mungunzul Amarbayan
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
| | - Kara Plotnikoff
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
| | - Krista Wollny
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Henry T. Stelfox
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Kirsten M. Fiest
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
- * E-mail:
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Hoffmann M, Sendlhofer G, Gombotz V, Pregartner G, Zierler R, Schwarz C, Tax C, Brunner G. Hand hygiene compliance in intensive care units: An observational study. Int J Nurs Pract 2019; 26:e12789. [PMID: 31670442 PMCID: PMC9285823 DOI: 10.1111/ijn.12789] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 08/23/2019] [Accepted: 09/07/2019] [Indexed: 12/19/2022]
Abstract
Aim Health care–associated infections along with antibiotic resistance are a leading risk for patient safety in intensive care units. Hygienic hand disinfection is still regarded as the most effective, simplest, and most cost‐effective measure to reduce health care–associated infections. To improve hand hygiene compliance and to prevent health care–associated infections, interventions of the “German Clean Hands Campaign” were implemented in a university hospital. Methods Observational single‐center study using direct observation and feedback. Hand hygiene performance was assessed in 12 intensive care units between 2013 and 2017. Linear mixed model regression analyses were used to estimate the compliance trend over time. Results In total, 10 315 “my five moments for hand hygiene” were observed. The mean hand hygiene compliance rates increased from 75.1% to 88.6% during the study period, yielding an estimated increase of about 4.5% per year. However, there are differences in compliance between occupational groups (physicians: between 61.2% and 77.1%; nurses: between 80.2% and 90.9%; others: between 61.3% and 82.4%). Conclusions After implementation of the “German Clean Hands Campaign” interventions, an overall significant improvement of hand hygiene was detected. Compliance measurements helped to raise awareness among health care professional groups. What is already known about this topic?
A significantly higher prevalence of infections has been observed in intensive care unit patients compared with patients in other wards. Hygienic hand disinfection is still regarded as the most effective, simplest, and most cost‐effective measure to reduce health care–associated infections. Low hand hygiene rates in intensive care units are a major problem for patient safety.
What is already known about this topic?
Implementation of the “German Clean Hands Campaign” showed continuous improvement in hand hygiene for all health care professionals in intensive care units over a period of 5 years. There are differences in compliance rates between health care profession and intensive care unit types. Pediatric intensive care units had the highest hand hygiene compliance rates.
The implications of this paper:
Overall, hand hygiene compliance in intensive care units increased over a period of 5 years after continuous campaigning, training, observation, compliance measurements, and direct feedback. It is necessary to raise awareness for hand hygiene in a repetitive manner within all health care professional groups now and in the future. Because of the differences in compliance rates between health care professionals, more tailored and evidence‐based interventions should be implemented.
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Affiliation(s)
- Magdalena Hoffmann
- Executive Department for Quality and Risk Management, University Hospital Graz, Graz, Austria.,Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Gerald Sendlhofer
- Executive Department for Quality and Risk Management, University Hospital Graz, Graz, Austria.,Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Veronika Gombotz
- Executive Department for Quality and Risk Management, University Hospital Graz, Graz, Austria
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Renate Zierler
- Department of Surgery, University Hospital Graz, Graz, Austria
| | - Christine Schwarz
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | | | - Gernot Brunner
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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