Cypress B, Gharzeddine R, Rosemary Fu M, Ransom M, Villarente F, Pitman C. Healthcare professionals perspective of the facilitators and barriers to family engagement during patient-and-family-centered-care interdisciplinary rounds in intensive care unit: A qualitative exploratory study.
Intensive Crit Care Nurs 2024;
82:103636. [PMID:
38301418 DOI:
10.1016/j.iccn.2024.103636]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES
Family engagement in care for critically ill patients remains an inconsistent practice and an understudied area of nursing science. Rounds for this study is an interdisciplinary activity conducted at the bedside in partnership with patients, their families, and the health care professionals involved in providing the care. We sought to explore and describe the facilitators and barriers to family engagement during patient and family-centered interdisciplinary rounds in the intensive care unit.
RESEARCH METHODOLOGY/DESIGN
This qualitative exploratory study is part of a multisite experimental study (#Pro2020001614; NCT05449990). We analyzed the narrative data from the qualitative questions added in the survey from 52 healthcare professionals involved in a multisite experimental study using Braun and Clarke's (2006) constructionist, contextualist approach to thematic analysis.
SETTING
The study was conducted in the intensive care unit of two medical centers.
MAIN OUTCOME MEASURES
The findings presented are themes illuminated from thematic analysis namely communication gaps, family's lack of resources, familial and healthcare providers' characteristics, lack of leadership, interprofessional support, policy, and guidelines.
FINDINGS
Family engagement in critical care during interdisciplinary rounds occurred within the intersectionality among families, healthcare professionals' practice, and organizational factors. The facilitators for family engagement include supported, championed, and advocated-for family adaptation, teams, and professional practice, and organizational receptivity, and support. Communication and leadership are the precursors to family engagement.
CONCLUSIONS
The findings added new knowledge for exploring the nature and scope of family engagement in critical care. Family engagement must be incorporated into the organizational vision and mission, and healthcare delivery systems.
IMPLICATIONS FOR CLINICAL PRACTICE
There is a need to further investigate the resources, organizational support mechanisms, and systems that affect patients, families, and healthcare professionals, and the establishment of policies that will aid in reducing barriers to family engagement in the intensive care unit.
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