[Perception of the critical patient on nursing cares: an approach to the concept of satisfaction]

Prehospital emergency care family satisfaction scale for care provided by emergency medical technicians: Scale development and validation

RATIONALE

To date, family satisfaction with emergency medical technicians (EMTs) has only been reported through narrative statements in subjective evaluations. Although a quantitative assessment of healthcare professional satisfaction is desirable, no specific measures have been devised to assess family satisfaction with the healthcare and care provided by EMTs.

AIMS AND OBJECTIVES

This study aimed to develop and validate an EMT care family satisfaction scale to measure patient satisfaction with prehospital emergency care.

METHODS

The study population comprised 216 family members (N = 216) of patients who used ambulances between November 2020 and May 2021 in a single region in Japan. Questionnaires were distributed to the participants who provided informed consent. An exploratory factor analysis of construct validity was performed to validate the Family Satisfaction Scale. The Cronbach's alpha was used to validate the internal consistency reliability of the scale.

RESULTS

The exploratory factor analysis results revealed a four-factor structure: 'explanation and communication,' 'physical treatment,' 'psychological support,' and 'environment in the ambulance.' The Cronbach's range (0.80-0.93) for the total score for each of these four factors and the overall total score confirmed favorable internal reliability of this study.

CONCLUSIONS

The family satisfaction scale developed in this study was constructed and validated to highlight the role of EMTs and needs of the families in the prehospital care settings. Moreover, this scale can be applied in the evaluation and consideration of interventions to improve family satisfaction with EMTs.

Patient satisfaction with nursing care in an Intensive Care Unit measured through the Nursing Intensive-Care Satisfaction Scale (NICSS)

BACKGROUND

Patient satisfaction in relation with nursing care has become a key determinant of the quality of hospital care.

OBJECTIVES

To evaluate patient satisfaction in relation with nursing care in a critical care context; to determine the correlation between critical patient satisfaction and sociodemographic and clinical variables and to describe patient perceptions with nursing care.

METHODS

A descriptive, prospective, correlational study which includes the analysis of some open questions in the intensive care unit (ICU) of a tertiary level university hospital. The degree of satisfaction of all patients discharged from de ICU was evaluated. It was used the validated Spanish version of Nursing Intensive-Care Satisfaction-Scale (NICSS). There were also collected sociodemographic and clinical data and 3 open questions were asked. It was used the inferential and descriptive statistics considering statistically significant p<.05. Open questions were examined using a language context analysis. The approval of the hospital ethical committee was obtained.

RESULTS

111 patients agreed to participate, with a mean age of 64.18 years (CI 95% 61.36-66.88) and with a medium level of satisfaction of 5.83 (CI 95% 5.78-5.88) being 6 the maximum score. Women, older patients and those who reflect a higher degree of recovery, are those who reported greater satisfaction. Three main themes emerged from the analysis of the open-ended questions of the surveys: nurse patient relationship, professional practice environment and ICU nature.

CONCLUSION

Patient satisfaction in relation with nursing care was elevated. Age, sex and degree of recovery significantly influenced their perception. Nurse patient relationship and the professional practice environment were aspects highlighted by patients. The professional model incorporated by the institution may encouraged these results.

Pain and Satisfaction Perceptions of Ultrasound-Guided Versus Conventional Peripheral Intravenous Catheterization: A Randomized Controlled Trial

BACKGROUND

While many emergency department (ED) patients need peripheral vascular catheterization, diagnosis and treatment are often delayed by difficult intravenous access (DIVA).

AIMS

This study of ED patients with DIVA was designed to evaluate ultrasound (US)-guided peripheral intravenous (IV) catheterization, compare it with conventional catheterization, and analyse patient pain and satisfaction regarding catheterization.

DESIGN

Randomized controlled clinical trial.

METHODS

Adult patients treated in the ED who scored >3 on the Adult-Difficult Venous Catheterization scale were randomly assigned to either US-guided or conventional peripheral IV catheterization. Data were collected from April to December 2016. Study variables were catheter insertion success, number of catheterization attempts, time required to perform the procedure, catheter length and calibre, puncture site, complications, and catheter functioning. Pain and patient satisfaction were also analysed for each group and the full sample.

RESULTS

120 and 138 patients were recruited for the US-guided and conventional peripheral IV catheterization groups, respectively. For the US-guided compared to the conventional procedure, insertion success was greater (91.75% versus 89.9%; p=0.04), the mean (SD) number of attempts was lower (1.29 (0.59) versus 1.81 (1.28); p<0.001), mean (SD) satisfaction was greater (7.59 (2.04) versus 6.69 (2.28); p=0.03), and the mean (SD) required time in minutes was greater (7.89 (7.13) versus 5.1 (3.69); p=0.045). Mean (SD) pain was moderate in both groups (4.6 (2.75) versus 4.33 (2.91) (p=0.32). Logistic regression for the full sample indicated that more attempts and greater pain were both associated with reduced satisfaction, while use of higher-calibre catheters was associated with greater satisfaction.

CONCLUSION

US-guided compared to conventional peripheral IV catheterization in patients with DIVA was more successful, required fewer attempts, enabled use of longer and higher-calibre catheters, and led to greater patient satisfaction. Patients who underwent US-guided intravenous catheterization reported moderate pain, similar to that reported for the conventional procedure.

CLINICAL IMPLICATIONS

US-guided peripheral intravenous catheterization improves ED patient care, as it requires fewer catheterization attempts. It is especially recommended for patients with DIVA.

Patient perceptions of ICU physiotherapy: 'Your body needs to go somewhere to be recharged … '

Background

Patient satisfaction is an essential concept to consider for the improvement of quality care in healthcare centres and hospitals and has been linked to increased patient compliance with treatment plans, better patient safety and improved clinical outcomes.

Objectives

As part of a before-and-after clinical trial aimed to investigate the implementation of an evidence-based and -validated physiotherapy protocol within a surgical intensive care unit (ICU), we decided to include the patient perception of physiotherapy received in the intervention unit.

Methods

A nested, exploratory, descriptive, qualitative study design was adopted. Purposively selected adult patients discharged from ICU during the implementation phase of the trial were interviewed.

Results

Eighteen patients (10 male) with a median age of 44 years and median ICU length of stay (LOS) of six days were included. Three themes and nine categories emerged: (i) linking therapy to clinical outcome (patient expectations and understanding; physiotherapy activities and the implication of mobilisation; physiotherapy benefits and progression); (ii) the importance of developing a trusting relationship (physiotherapy value; safety; continuity of care); and (iii) communication (satisfaction; interactions and patient perception and experience of physiotherapy).

Conclusion

While confirming barriers to early mobility, patients perceived participation in mobility activities as a marked jolt in their journey to recovery following a critical incident. Effective communication and preservation of trust between physiotherapist and patient are essential for understanding expectations and can facilitate improved outcomes. Clinicians can use the information when managing critically ill patients. Including patient-reported outcomes to measure physiotherapy interventions used in the ICU is feasible and can inform the development of such outcomes.

Contribution of the study

The study highlights the feasibility and importance of the use of patient-reported outcomes to measure physiotherapy interventions and informs the development of patient reported outcomes and the importance of patient centred physiotherapy care in the ICU setting.

Satisfaction of intensive care unit patients linked to clinical and organisational factors: A cross-sectional multicentre study

BACKGROUND

The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care.

OBJECTIVES

The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables.

DESIGN

This was a prospective, descriptive correlational study.

SETTING AND METHODS

The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected.

RESULTS

Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p < 0.001) and the type of ICU (p=<0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU.

CONCLUSION

Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.

National validation of the nursing Intensive-Care satisfaction scale: Research protocol

AIM

Validate the Nursing Intensive-Care Satisfaction Scale in ICUs throughout Spain. Identify the improvement strategies recommended by the patients and professionals.

DESIGN

Quantitative psychometric methodology and a cross-sectional descriptive correlational design.

METHODS

The study population will be all patients discharged from 19 participating ICUs in Spain. Consecutive sampling (n = 564). Once discharged from the ICUs, they will receive the questionnaire and then, after 48 hours it will be given to them again to analyse the temporal stability. To validate the questionnaire, the internal consistency (Cronbach's Alpha) and temporal stability (test-retest) will be analysed.

RESULTS

Improve the quality of nursing care by modifying, changing or strengthening behaviours, skills, attitudes or areas for improvement involved in the process.

Emergency Nursing-Care Patient Satisfaction Scale (Enpss): Development and Validation of a Patient Satisfaction Scale with Emergency Room Nursing

This study aimed to develop and validate an emergency nursing-care patient satisfaction scale to measure patient satisfaction with emergency room (ER) nursing. Patient satisfaction scales for ER nursing have been validated without considering the perspectives of the healthcare system or cultural background of the country. Moreover, although nursing care is changing with COVID-19, no scale has been specifically designed to assess patient satisfaction with ER nursing. The study population included patients who visited five ERs in Japan (March to December 2021) (n = 135). The rating scales were provided to patients who visited the ER and gave consent, and the patients were asked to reply. In the process of validating the scale, exploratory and confirmatory factor analyses of the construct and criterion validity were conducted. The confirmatory factor analysis results showed a factorial structure consisting of four factors. The domain and summary scores demonstrated good-to-excellent internal reliability (Cronbach’s range = 0.81–0.89). This patient satisfaction scale was designed and validated from the perspective of the Japanese healthcare system and cultural backgrounds. This scale may be useful for developing assessments and interventions to improve patient satisfaction with ER nursing.

Satisfaction of patients and family caregivers in adult intensive care units: Literature Review

Intensive care units are hostile places, which must be conditioned to the needs of patients and families, and therefore the factors that influence their satisfaction must be known.

OBJECTIVE

To update the knowledge on the satisfaction of the patients admitted to an adult intensive care unit and that of their family caregivers as described in the scientific literature.

METHODOLOGY

A systematized literature review was carried out in PubMed, Scopus, Cinahl and WOS databases.

SEARCH STRATEGY

"Personal Satisfaction" and (patients or caregivers) and "Intensive Care Units".

INCLUSION CRITERIA

studies published between 2013-2018, population aged between 19-64 years, English and Spanish language.

RESULTS

760 studies were located and 15 were selected. The factors that increased satisfaction are: good communication with professionals (n = 5), the quality of care (n = 4), and the cleanliness and environment of the units (n = 2). The factors that produced dissatisfaction are: the infrastructure of the waiting room (n = 5), inadequate communication (n = 4), and the involvement of families and patients in decision-making (n = 4). Training of professionals (n = 5), inclusion of the family during the process of hospitalization (n = 2) and redesigning the waiting room (n = 2) are some of the suggestions for improvement.

CONCLUSIONS

Factors related to professionals, environment and cleanliness of the units are satisfaction-generating factors. Factors generating dissatisfaction related to poor infrastructure, a lack of involvement in decision-making and poor professional communication. Strategies to improve patient and family satisfaction relate to the organization, professionals, family members, and infrastructure and environment.

Mixed-method research protocol: Development and evaluation of a nursing intervention in patients discharged from the intensive care unit

AIM

(a) To understand patients' lived experience at intensive care unit (ICU) discharge and (b) to evaluate the impact of a nursing empowerment intervention (NEI) on patients' anxiety and depression levels at ICU discharge.

DESIGN

A mixed-methods approach will be applied.

METHODS

In the qualitative phase, the hermeneutic phenomenological method will be used. Participants will be patients from three university hospitals who will be selected by purposive sampling. Data will be gathered through in-depth interviews and analysed using content analysis. The qualitative data obtained will be employed to develop the nursing intervention. Subsequently, a multicenter, parallel-group, experimental pre-test/post-test design with a control group will be used to measure the effectiveness of the nursing empowerment intervention in the quantitative phase by means of the Hospital Anxiety and Depression Scale (HADS). Simple random probabilistic sampling will include 172 patients in this phase.

Humanizing Intensive Care: From Theory to Practice

The International Research Project for the Humanization of Intensive Care Units (Proyecto HU-CI) was initiated in 2014. The aim of this project is to change the current paradigm toward a human-centered care model. Patients, families, and professionals (everyday stakeholders) were asked to describe their ideal intensive care unit (ICU). Using their opinions, 8 fields of research to improve the management of ICUs and change the reality of care throughout the world were designed. This replicable tested model to humanize the ICU care delivery model is presented.

Satisfaction of patients and family caregivers in adult intensive care units: Literature Review

Intensive care units are hostile places, which must be conditioned to the needs of patients and families, and therefore the factors that influence their satisfaction must be known.

OBJECTIVE

To update the knowledge on the satisfaction of the patients admitted to an adult intensive care unit and that of their family caregivers as described in the scientific literature.

METHODOLOGY

A systematized literature review was carried out in PubMed, Scopus, Cinahl and WOS databases.

SEARCH STRATEGY

"Personal Satisfaction" and (patients or caregivers) and "Intensive Care Units".

INCLUSION CRITERIA

studies published between 2013-2018, population aged between 19-64 years, english and spanish language.

RESULTS

760 studies were located and 15 were selected. The factors that increased satisfaction are: good communication with professionals (n=5), the quality of care (n=4), and the cleanliness and environment of the units (n=2). The factors that produced dissatisfaction are: the infrastructure of the waiting room (n=5), inadequate communication (n=4), and the involvement of families and patients in decision-making (n=4). Training of professionals (n=5), inclusion of the family during the process of hospitalization (n=2) and redesigning the waiting room (n=2) are some of the suggestions for improvement.

CONCLUSIONS

Factors related to professionals, environment and cleanliness of the units are satisfaction-generating factors. Factors generating dissatisfaction related to poor infrastructure, a lack of involvement in decision-making and poor professional communication. Strategies to improve patient and family satisfaction relate to the organization, professionals, family members, and infrastructure and environment.

Level of satisfaction of critical care patients regarding the nursing care received: Correlation with sociodemographic and clinical variables

BACKGROUND

The satisfaction of critical care patients regarding the nursing care received is a key indicator of the quality of hospital care. It is, therefore, essential to identify the factors associated with the level of satisfaction of critical care patients.

OBJECTIVES

To analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and the sociodemographic and clinical variables.

METHODS

This is a prospective and descriptive correlational study. The population were all patients discharged (January 2013 to January 2015) from three intensive care units of a third-level hospital (n = 200). The data on the satisfaction level were collected using the previously validated Nursing Intensive-Care Satisfaction Scale, and the sociodemographic and clinical data were recorded by means of a questionnaire.

RESULTS

Mean participants' age in the study (n = 200) was 65.9 years (standard deviation 13.4 years), with a 66% proportion of men (n = 132). There was a very high level of satisfaction regarding the nursing care received during the patients' stay in the intensive care unit, with a rating of 5.73 (standard deviation 0.41). There is no correlation between the level of satisfaction and the sociodemographic variables collected. However, there were statistically significant differences in the average score of the overall level of satisfaction (rho = 0.182, p = 0.010) with respect to the perception of the state of health.

CONCLUSION

Critical care patients expressed very high rates of satisfaction, for both the scale as a whole and each of the factors. A high level of satisfaction is strongly influenced by the perception of the state of health.

[Satisfaction with care received in pediatric emergency services: impact of family interaction and emotional disturbance]

This study addresses the relationship between two key elements in satisfaction with pediatric emergency services, namely emotional disturbance and family interaction. The main goal is to determine whether family cohesion and adaptability and anger may be associated with differential levels of satisfaction among parents whose children were attended in pediatric emergency units. It is a descriptive study for which a sample of 711 parents whose children were attended in 6 pediatric emergency services was studied. The Spanish version of the State-Trait Anger Expression Inventory-2 (Staxi-2), the Satisfaction with Healthcare Services Scale and the Family Adaptability and Cohesion Evaluation Scale (Faces) were used respectively. Data analysis included a Spearman bivariate correlations analysis, Kruskal Wallis, Mann-Whitney test and path-analysis using a structural equations model. The results support the hypothesis that higher levels of family cohesion and adaptability as well as lower levels of anger are associated with higher levels of satisfaction among parents.

Nursing Intensive-Care Satisfaction Scale [NICSS]: Development and validation of a patient-centred instrument

AIM

The aim of this study was to develop and validate the Nursing Intensive-Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective.

BACKGROUND

Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units.

DESIGN

Instrument development.

METHODS

The population were all discharged patients (January 2013 - January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity.

RESULTS

Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42-0.68).

CONCLUSIONS

The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care.

“No es fácil estar 24 horas en una cama”: confort del paciente con sedación en una unidad de cuidado intensivo

Objetivo: comprender el significado que tiene para el enfermero el confort del paciente en estado crítico, que se encuentra bajo efectos de sedación en la unidad de cuidado intensivo. Materiales y métodos: enfoque cualitativo, con herramientas de la etnografía particularista; se realizaron 100 horas de observación, 9 entrevistas, 1 grupo focal y registro en el diario de campo; lo anterior permitió triangular, codificar y categorizar la información para obtener una visión total del fenómeno; se garantizó la confidencialidad de los participantes. Resultados: el significado que le otorgan los enfermeros al confort del paciente bajo efectos de sedación es “estar tranquilo”, entendido como la armonía entre tres filiaciones: ambiente y compañía, comodidad y protección, analgesia y sedación, cada una con elementos excluyentes pero interdependientes, que determinan la tranquilidad del paciente. Conclusiones: el paciente en estado crítico, bajo efectos de sedación, no es consciente de sus necesidades, por tanto, depende del enfermero para identificarlas y satisfacerlas. Para ello, el enfermero interpreta los signos manifestados por el paciente y aplica el cuidado compasivo, para brindar confort a la persona cuidada.

Experiencia de estar hospitalizado en una unidad de cuidado intensivo coronario de Barranquilla

<p>La experiencia de estar hospitalizado en una unidad de cuidado intensivo genera ansiedad, angustia y estrés en la persona. Los pacientes con enfermedad coronaria requieren de cuidados especiales en este tipo de unidades, por lo que las percepciones, sentimientos y vivencias del paciente durante su estancia en la unidad se constituyen en elementos significativos de su experiencia. Objetivos: Conocer el significado de las experiencias vividas en una unidad de cuidado intensivo coronario de una clínica de Barranquilla. Metodología: Estudio cualitativo, descriptivo, con enfoque fenomenológico, en el que se entrevistaron nueve pacientes entre 59 y 74 años que estuvieron hospitalizados en una unidad de cuidado intensivo coronario con diagnóstico de infarto agudo de miocardio. Como estrategia de investigación, se utilizó el método de Colaizzi, siguiendo cada uno de los pasos sugeridos y guardando el rigor ético correspondiente. Resultados: Se identificaron cuatro categorías que reflejan de forma exhaustiva el fenómeno estudiado: 1) El primer contacto con la unidad 2) Lo malo de estar hospitalizado en la unidad 3) Confianza en Dios y 4) Pérdida de la percepción del tiempo. Conclusiones: Las vivencias expresadas por los participantes corroboran lo hallado en estudios similares, los cuales convergen al afirmar que el ingreso a la unidad de cuidado intensivo genera una serie de sentimientos negativos en la persona, que marcan de manera significativa su experiencia de vida. Pero también influyen aspectos positivos derivados de la atención humanizada del personal de enfermería.</p>

[Analysis of the intensity of professional collaboration among nurses in a critical care area]

OBJECTIVE/S

To analyse the intensity of professional collaboration (IPC) between the nurses in a multidisciplinary critical area (CA) and the relationship with the workplace "intensive care unit (ICU) and special hospitalisation area (SHA)", educational level, age, and years of professional activity in CA.

METHOD

A cross-sectional descriptive study was conducted with 57 nurses from CA, recording socio-demographic data: age, educational level, speciality titles, years of professional activity and workday type, years of professional activity in the CA, and involvement in scientific works. Tool: Intensity of Inter-professional Collaboration Questionnaire.

STATISTICAL ANALYSIS

SPSS 20.0.

RESULTS

The study included a total of 47 nurses (ICU/SHA), with a mean age of 35.91 (9.59) years. Almost three-quarters (74.46%) were nursing graduates with a posgraduate in ICU. Median and interquartile range of professional experience was 14 and 14.50 years, respectively, and years working in CA was 8.50 and 16 years, respectively. Just over half of them (51.10%) worked part-time, and 61.70% participated in scientific works. The mean IPC score was 61.68 (6.84), with 57.40% providing values of high IPC. The relationship between the workplace (ICU/SHA) and educational level with IPC was not statistically significant (p>.05). There are statistical significant differences between IPC with age and years of professional activity in CA (p<.05).

CONCLUSIONS

The present study demonstrates the existence of good IPC in the CA. Younger nurses obtain a better IPC score, as well as nurses who have been working for less time in CA. Nurses with a Degree or Masters have a higher level of IPC than the rest, as well as nurses who perform professional activity combining ICU and SHA.

[Perception of UCI nurses in relation with satisfactory care: convergences and divergences with the perception of critical patients]

OBJECTIVE

Explore convergences and divergences between perception of nurses and of critically ill patients, in relation to the satisfactory care given and received.

METHODS

It is part of a larger qualitative study, according to the Grounded Theory. Carried out in 3 intensive care units with 34 boxes. Sampling theoretical profiles with n=19 patients and n=7 nurses after data saturation. Recruitment of patients included in the profiles of elderly and long-stay got stretched over some time due to the low incidence of cases. Data collection consisted of: in-depth interview to critically ill patients, group discussion of expert nurses in the critical care patient and field diary. Analysis themed on Grounded Theory according Strauss and Corbin: open coding, axial and selective. Analysis followed criteria of Guba and Lincoln rigor, Calderón quality and Gastaldo and McKeever ethical reflexivity. There was a favorable report from the ethical committee of the Hospital and informed consent of the participants.

RESULTS

Four matching categories were found: professional skills, human, technical and continued care. Combination of these elements creates feelings of security, calmness and feeling like a person, allowing the patient a close and trusting relationship with the nurse who takes individualized care. Not divergent categories were found.

CONCLUSIONS

Perceptions of nurses in relation to care match perceptions of critically ill patients in both the definition and dimensions upon satisfactory care.