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Højbjerg K, Poulsen I, Egerod I. Facilitators and inhibitors of traumatic brain injury transfers: A fieldwork investigation. Nurs Open 2023; 10:6282-6290. [PMID: 37317011 PMCID: PMC10416057 DOI: 10.1002/nop2.1874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 01/30/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023] Open
Abstract
AIM Intensified healthcare specialization has increased the need for patient transfers. We aimed to describe in-hospital and interhospital patient transfer decisions during the traumatic brain injury (TBI) trajectory from a nursing perspective. DESIGN Ethnographic fieldwork. METHODS We used participant observation and interviews at three sites representing the acute, subacute and stable stages of the TBI trajectory. Deductive analysis was applied supported by transition theory. RESULTS During the acute stage (neurointensive care), transfer decisions were facilitated by physicians assisted by critical care nurses, in the subacute stage (highly specialized rehabilitation), transfer decisions were collaborative among in-house healthcare professionals, community staff and family, and during the stable stage (municipal rehabilitation), transfer decisions were made by non-clinical staff. Most of the resources allocated during the trajectory went towards highly specialized rehabilitation, whereas more resources are needed during the end of the trajectory. NO PATIENT OR PUBLIC CONTRIBUTION Patients and the public were not involved in this study .
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Affiliation(s)
- Karin Højbjerg
- Department of Learning and PhilosophyAalborg University CopenhagenCopenhagenDenmark
- Present address:
Department of Nursing and Nutrition, Faculty of HealthCopenhagen University CollegeCopenhagen NDenmark
| | - Ingrid Poulsen
- Department of Brain Injury, Copenhagen University HospitalRigshospitaletCopenhagenDenmark
- Department of Nursing Science, HealthAarhus UniversityAarhusDenmark
- Present address:
Department of Clinical ResearchCopenhagen University Hospital, Amager and HvidovreHvidovreDenmark
| | - Ingrid Egerod
- Department of Intensive Care, Copenhagen University HospitalRigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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Zhan Y, Yu J, Zhang W, Wan Y, Chen Y, Wang Y, Li S. Cognition and practice on transitional care during the transfer from intensive care unit to a general ward among health care professionals: A qualitative study. J Nurs Manag 2022; 30:4569-4577. [PMID: 36281794 DOI: 10.1111/jonm.13878] [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: 03/28/2022] [Revised: 07/21/2022] [Accepted: 10/02/2022] [Indexed: 12/30/2022]
Abstract
AIM The aim of this study is to explore the cognition and practice on transitional care during the transfer from intensive care unit to a general ward among health care professionals in China. BACKGROUND Due to the significant differences in the medical and humanistic environment at home and abroad, the safety of patients during the transmission from intensive care unit to the general ward is often ignored when their conditions become stable. There are few qualitative studies on the cognition and practice on transitional care during the transfer from intensive care unit to the ward among health care professionals in China. METHODS With a qualitative research design, 20 medical and nursing staff in the neurosurgery intensive care unit and ward were interviewed from May 2021 to August 2021. NVivo 11.0 software was utilized for Colaizzi's (1978) method of data analysis. RESULTS Based on data analysis, perceptions of transitional care, the influencing factors for transitional care and the recommendations for improving transitional care were obtained. CONCLUSION To ensure the continuity of care and improve patient safety during the period from intensive care unit to a general ward in China, we should clarify the expectation for the content of intensive care unit transitional care services, establish the transitional nursing team, guide nursing work, standardize the handover mode and process from intensive care unit to the general ward, promote the communication and coordination of health care professionals and improve the transitional nursing security system from the perspective of institutional level. IMPLICATIONS FOR NURSING MANAGEMENT This study can be used as a guide to help health care professionals provide a reference for the comprehensive development of transitional care services and the formulation of targeted intervention measures during the transfer from intensive care unit to a general ward in China.
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Affiliation(s)
- Yuxin Zhan
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaohua Yu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenya Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Wan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinyue Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suyun Li
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Chen SM, Wu CJ. Development and validation of a Perceived Relocation Stress Scale for older individuals transferred to long-term care facilities in Taiwan. Int Health 2022:6612122. [PMID: 35726866 DOI: 10.1093/inthealth/ihac041] [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: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of the current study was to develop and validate a Perceived Relocation Stress Scale. METHODS A cross-sectional research design was used. A total of 175 older adults residing in long-term care facilities in Southern Taiwan for at least 1 y were recruited. An exploratory factor analysis was performed to examine item convergent and discriminant validity. Concurrent validity was checked using the Depression Anxiety and Stress scale. The reliability was analyzed using Cronbach's alpha and intraclass correlation coefficients. RESULTS The face and content validity of the scale were verified by adequately measuring the scale items. Factor analysis consisted of four components (challenge/chance, positive appraisal, threat, loss), with a total variance of 67.35%. The content validity was determined by an expert panel to systematically examine the relevance of all items. The results of item convergent and discriminant validity supported the constructs of the scale. The alpha coefficient for the overall scale was .958, indicating good internal consistency reliability. CONCLUSIONS The Perceived Relocation Stress Scale is a reliable and valid measurement to assess the stress perceived by older individuals being transferred to a long-term care facility.
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Affiliation(s)
- Shu-Ming Chen
- School of Nursing, Fooyin University, 151 Jinxue Road, Dailao Dist., Kaohsiung City, 83102, Taiwan
| | - Chiung-Jung Wu
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, 1 Moreton Parade, Petrie, QLD 4502, Australia.,Royal Brisbane and Women's Hospital (RBWH), Australia
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Li B, Yang Q. The effect of an ICU liaison nurse-led family-centred transition intervention program in an adult ICU. Nurs Crit Care 2022; 28:435-445. [PMID: 35396917 DOI: 10.1111/nicc.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND ICUs follow a restrictive companionship policy, especially after the COVID-19 outbreak. This strategy often limits the time families spend with patients, hinders their knowledge and skills in caregiving, and the sudden transfer of ICU patients to assist with disease monitoring and daily care can be very stressful for families. It is beneficial to use the transition period of transferring ICU patients to help families adjust to the role of caregiver. AIMS AND OBJECTIVES To develop and implement a patient- and family-centered transitional care intervention plan for patients transferred to the ICU. DESIGN Prospective, pretest and posttest design. METHODS The experimental group received an individualized family-centered transition plan led by the ICU liaison nurse that included 1) communication with health care professionals; distribution of a transfer booklet; 2) identification of nursing issues and communication with the ward nurse; invitation of family members to participate in the patient's rehabilitation; 3) follow-up instruction on bedside range of motion exercises; and provision of a patient rehabilitation diary. Patients in the control group received only routine care. Data were collected using the General Information Questionnaire, Family Satisfaction with ICU Patients (FS-ICU), the Family Relocation Stress Scale (FRSS), and the Stanford Acute Stress Response Questionnaire (SASRQR). RESULTS After the intervention, the total family satisfaction score of ICU patients in the experimental group was significantly higher than that of the control group (87.18 ± 8.38 vs 78.74 ± 10.63, p<0.001), and the satisfaction with the care and information provided was significantly higher in the experimental group compared to the control group (p < 0.001), with no significant difference between the two groups in terms of satisfaction with decision making (p>0.001). The level of relocation stress of patients' families was significantly lower in the experimental group compared to the control group after the intervention (p < 0.001). And there was no statistically significant difference between the two groups in terms of patients' acute stress disorder scores (p>0.001). CONCLUSION The implementation of a family-involved transition care programme significantly improved the satisfaction of ICU patients' families and reduced the stress of relocation for patients' families. RELEVANCE TO CLINICAL PRACTICE Focusing on the transition of ICU patients to ensure continuity of critical care and improve the quality of care for ICU patient transfers can be accomplished through a family-centered transition care plan led by the ICU liaison nurse.
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Affiliation(s)
- Baiyu Li
- Department of Comprehensive Intensive Care Unit, Affiliated Hospital of Yangzhou University, Yangzhou First People's Hospital, Yangzhou, Jiangsu, China.,Nursing College of Yangzhou University, Yangzhou, Jiangsu, China
| | - Qin Yang
- Department of Comprehensive Intensive Care Unit, Affiliated Hospital of Yangzhou University, Yangzhou First People's Hospital, Yangzhou, Jiangsu, China.,Nursing College of Yangzhou University, Yangzhou, Jiangsu, China
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Fults MZ, McDonald C, Russell S, Folenta D, Whichard F, Ritchie AD, Murphy T. Intra-NICU Patient Transfers: A Study of Frequency and Family and Staff Perceptions. Neonatal Netw 2022; 41:94-99. [PMID: 35260426 DOI: 10.1891/11-t-691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 11/25/2022]
Abstract
AIMS (a) Quantify frequency of patient moves within a NICU with single patient and semi-private rooms (SPR). (b) Compare staff and parent perceptions of these moves. METHODS A hospital administrative database was evaluated to quantify the frequency of moves. A Room Change Questionnaire was devised to evaluate perceptions from NICU families and staff. RESULTS Most families reported experiencing at least 1 patient move (92 percent), with the majority reporting at least 3 moves (58 percent). Staff perceived moves as negative significantly more than parents (p < .01), and overreported negative family perceptions (p < .01). Overall, moves did not bother families (52 percent); however, most families who moved 3 or more times reported at least 1 negative perception (63 percent). CONCLUSION SFRs increase the number of patient moves. NICU staff's perception is significantly more negative than family's perception; however, most families who were moved frequently reported at least 1 negative perception.
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Won MH, Son YJ. Development and psychometric evaluation of the Relocation Stress Syndrome Scale-Short Form for patients transferred from adult intensive care units to general wards. Intensive Crit Care Nurs 2020; 58:102800. [DOI: 10.1016/j.iccn.2020.102800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 12/05/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
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Research Article Women's experience of maternity high-dependency care following a complicated birth: A cross-sectional study. Intensive Crit Care Nurs 2019; 53:54-59. [PMID: 30878536 DOI: 10.1016/j.iccn.2019.02.003] [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: 10/09/2018] [Revised: 12/17/2018] [Accepted: 02/11/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE There is limited evidence around childbearing women's experience following a complicated birth requiring maternity high-dependency care. Our objective was to explore women's experience and wellbeing following a complicated birth within this context. RESEARCH METHODOLOGY/DESIGN A cross-sectional study captured women's experience through a postal survey four weeks post birth. SETTING A convenience sample of 112 women who received care in the first 24 hours of their stay in a Western Australian maternity high dependency unit. MAIN OUTCOME MEASURES A validated tool designed to explore patients' intensive care experience was modified and six items were added based upon the literature and in consultation with clinicians. RESULTS Women felt they were given choice (78%; n = 86); were not glad to be transferred to a ward (62%; n = 68) and were in pain during the first 24 hours of their admission (70%; n = 78). Women who did not feel scared were more likely than those who felt scared to have a clinician explain what had happened (95% vs 78%, P = 0.007); were more likely to feel in control (94% vs 75%, P = 0.006); and were less likely to feel helpless (27% vs 62%, P = <0.001). CONCLUSION The transfer experience to a postpartum ward requires further investigation as does the management of pain for these childbearing women regardless of their birth mode.
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Padilla Fortunatti C, Rojas Silva N. Families on adult intensive care units: Are they really satisfied? A literature review. Aust Crit Care 2018; 31:318-324. [DOI: 10.1016/j.aucc.2017.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/05/2017] [Accepted: 08/15/2017] [Indexed: 10/19/2022] Open
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Min J, Kim Y, Lee JK, Lee H, Lee J, Kim KS, Cho YJ, Jo YH, Ryu HG, Kim K, Lee SM, Lee YJ. Survey of family satisfaction with intensive care units: A prospective multicenter study. Medicine (Baltimore) 2018; 97:e11809. [PMID: 30095649 PMCID: PMC6133602 DOI: 10.1097/md.0000000000011809] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 07/17/2018] [Indexed: 11/26/2022] Open
Abstract
Although family satisfaction is an important indicator for quality improvement of intensive care units (ICUs), few studies have translated family satisfaction data into quality improvement in Asia. A prospective multicenter study was conducted to evaluate family satisfaction regarding the care of patients and their family.The family satisfaction in the ICU (FS-ICU) questionnaire was administered from January 2015 to February 2016 at ICUs of 3 tertiary teaching hospitals in South Korea. Family members of adult patients, staying at an ICU for ≥48 hours, were included. Key factors affecting satisfaction were identified using quantitative and qualitative analyses.In total, 200 family members participated in this survey. The mean score for overall family satisfaction (FS-ICU/total) was 75.4 ± 17.7. The mean score for satisfaction with information/decision-making was greater than that for satisfaction with care (78.2 ± 18.2 vs 73.5 ± 19.4; P ≤ .001). Family members who agreed to not resuscitate and whose patient died at the ICU had lower FS-ICU/total scores. When compared with hospital A, hospital C was an independent predictor with an FS-ICU/total score of <75. Families reported the least satisfaction for the atmosphere of the ICU, including the waiting room atmosphere and management of agitation.We evaluated family satisfaction regarding ICUs for the first time in Asia using a validated tool. The decision to not resuscitate, ICU mortality, and ICU culture were associated with family satisfaction with critical care. Efforts should be targeted for improving factors that cause low family satisfaction when planning quality improvement interventions for ICUs in Asia.
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Affiliation(s)
- Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon
| | - Youlim Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Jung-Kyu Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center
| | | | - Jinwoo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Kyung Su Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul
| | - Young-Jae Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - You Hwan Jo
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | | | - Kyuseok Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sang-Min Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Yeon Joo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
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Lee S, Oh H, Suh Y, Seo W. A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward. J Clin Nurs 2016; 26:784-794. [PMID: 27570934 DOI: 10.1111/jocn.13568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. BACKGROUND Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. DESIGN A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. METHODS The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. RESULTS This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. CONCLUSIONS Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. RELEVANCE TO CLINICAL PRACTICE The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress management and make meaningful contribution to the relief of family relocation stress, promote patient recovery and enhance the well-being of patients and family caregivers.
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Affiliation(s)
- Seul Lee
- Inha University Hospital, Incheon, Korea
| | - HyunSoo Oh
- Department of Nursing, Inha University, Incheon, Korea
| | - YeonOk Suh
- Department of Nursing, Soonchunhyang University, Asan, Korea
| | - WhaSook Seo
- Department of Nursing, Inha University, Incheon, Korea
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