Pamela L Smithburger1,2,3,4, Amanda S Korenoski5,6,7,8, Sheila A Alexander5,6,7,8, Sandra L Kane-Gill5,6,7,8. 1. Pamela L. Smithburger is an associate professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, Pennsylvania. She practices in the medical intensive care unit at UPMC Presbyterian Hospital, Pittsburgh, Pennsylvania. smithburgerpl@upmc.edu. 2. Amanda S. Korenoski is an assistant professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, Pennsylvania. She is also the managing director of the Pittsburgh Poison Center, Pennsylvania. smithburgerpl@upmc.edu. 3. Sheila A. Alexander is an associate professor of Acute and Tertiary Care Nursing at the University of Pittsburgh School of Nursing, Pennsylvania. smithburgerpl@upmc.edu. 4. Sandra L. Kane-Gill is an associate professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, Pennsylvania. smithburgerpl@upmc.edu. 5. Pamela L. Smithburger is an associate professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, Pennsylvania. She practices in the medical intensive care unit at UPMC Presbyterian Hospital, Pittsburgh, Pennsylvania. 6. Amanda S. Korenoski is an assistant professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, Pennsylvania. She is also the managing director of the Pittsburgh Poison Center, Pennsylvania. 7. Sheila A. Alexander is an associate professor of Acute and Tertiary Care Nursing at the University of Pittsburgh School of Nursing, Pennsylvania. 8. Sandra L. Kane-Gill is an associate professor of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy, Pennsylvania.
Abstract
BACKGROUND: Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient's family are needed. OBJECTIVE: To gain insight into opinions of patients' families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients' families in such activities. METHODS: Purposeful sampling was used. Patients' families were contacted to be interviewed about their opinions and attitudes on participation in nonpharmacologic delirium prevention activities while visiting the intensive care unit. An interview guide was created and used to facilitate discussion. Interviews were conducted, transcribed verbatim, and coded by 2 independent coders. Themes were identified, defined, and compared between independent coders; disagreements were resolved by the study team. RESULTS: After 10 interviews were conducted, thematic saturation occurred. Three major themes emerged: (1) consistent family presence and participation in care, (2) improving ease of interactions between family and patient, and (3) delirium education for families. CONCLUSION: Family members want to be involved with care and delirium prevention; however, many times they do not know what to do without the direction of a health care provider. Family members would benefit from open dialogue with the bedside nurse to increase family comfort and involvement in care.
BACKGROUND: Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient's family are needed. OBJECTIVE: To gain insight into opinions of patients' families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients' families in such activities. METHODS: Purposeful sampling was used. Patients' families were contacted to be interviewed about their opinions and attitudes on participation in nonpharmacologic delirium prevention activities while visiting the intensive care unit. An interview guide was created and used to facilitate discussion. Interviews were conducted, transcribed verbatim, and coded by 2 independent coders. Themes were identified, defined, and compared between independent coders; disagreements were resolved by the study team. RESULTS: After 10 interviews were conducted, thematic saturation occurred. Three major themes emerged: (1) consistent family presence and participation in care, (2) improving ease of interactions between family and patient, and (3) delirium education for families. CONCLUSION: Family members want to be involved with care and delirium prevention; however, many times they do not know what to do without the direction of a health care provider. Family members would benefit from open dialogue with the bedside nurse to increase family comfort and involvement in care.
Authors: Kirsten M Fiest; Karla D Krewulak; Bonnie G Sept; Krista L Spence; Judy E Davidson; E Wesley Ely; Andrea Soo; Henry T Stelfox Journal: BMC Health Serv Res Date: 2020-05-24 Impact factor: 2.655
Authors: Karla D Krewulak; Margaret J Bull; E Wesley Ely; Judy E Davidson; Henry T Stelfox; Kirsten M Fiest Journal: Can J Anaesth Date: 2020-09-21 Impact factor: 6.713