Access to information; Family; Family information meeting; ICU; Information to family; Post-intensive care syndrome; Visiting policy
Abstract :
[en] BACKGROUND: The relatives of intensive care unit (ICU) patients must cope with both the severity of illness of their loved one and the unfamiliar and stressful ICU environment. This hardship may lead to post-intensive care syndrome. French guidelines provide recommendations on welcoming and informing families of ICU patients. We questioned whether and how they are applied 5 years after their publication. METHODS: We conducted a large survey among French ICUs to evaluate their visiting policies and how information was provided to patient's family. A questionnaire was built up by intensivists and nurses. French ICUs were solicited, and the questionnaire was sent to all participating ICUs, for being filled in by the unit medical and/or nursing head. Data regarding the hospital and ICU characteristics, the visiting policy and procedures, and the management of family information were collected. RESULTS: Among the 289 French ICUs, 188 (65 %) participated. Most ICUs have a waiting room 118/188 (62.8 %) and a dedicated room for meeting the family 152/188 (80.8 %). Of the 188 ICUs, 45 (23.9 %) were opened on a 24-h-a-day basis. In the remaining ICUs, the time period allowed for visits was 4.75 +/- 1.83 h (median 5 h). In ICUs where visiting restrictions were reported, open visiting was allowed for end-of-life situations in 107/143 (74.8 %). Children are allowed to visit a patient in 164/188 (87.2 %) regardless of their age in 97/164 (59.1 %) of ICUs. Families received an information leaflet in 168/188 (89.3 %). Information was provided to families through structured meetings in 149/188 (79.2 %) of ICUs at patient admission with participation of nurses and nursing assistants in 133/188 (70.4 %) and 55/188 (29.2 %), respectively. Information delivered to the family was reported in the patient chart by only 111/188 ICUs (59 %). Participation in care was infrequent. CONCLUSIONS: Although French ICUs do not follow the consensus recommendations, slow progress exists compared to previous reports. Implementation of these recommendations is largely needed to offer better welcome and information improvement. Further studies on that topic would enable evaluating remaining obstacles and increasing caregivers' awareness, both critical for further progresses on that topic.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Garrouste-Orgeas, Maite
Vinatier, Isabelle
Tabah, Alexis
Misset, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs
Timsit, Jean-François
Language :
English
Title :
Reappraisal of visiting policies and procedures of patient's family information in 188 French ICUs: a report of the Outcomerea Research Group.
Bailey JJ, Sabbagh M, Loiselle CG, Boileau J, McVey L. Supporting families in the ICU: a descriptive correlational study of informational support, anxiety, and satisfaction with care. Intensive Crit Care Nurs. 2010;26:114–22.
Anderson WG, Arnold RM, Angus DC, Bryce CL. Post-traumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Intern Med. 2008;23:1871–6.
Downar J, Barua R, Sinuff T. The desirability of an intensive care unit (ICU) clinician-led bereavement screening and support program for family members of ICU Decedents (ICU Bereave). J Crit Care. 2014;29:311-e9–316-e9.
Pochard F, Azoulay E, Chevret S, Lemaire F, Hubert P, Canoui P, et al. Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity. Crit Care Med. 2001;29:1893–7.
Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, et al. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005;171:987–94.
Kentish-Barnes N, Chaize M, Seegers V, Legriel S, Cariou A, Jaber S, et al. Complicated grief after death of a relative in the intensive care unit. Eur Respir J. 2015;45:1341–52.
Van Beusekom I, Bakhshi-Raiez F, de Keizer NF, Dongelmans DA, Van der Schaaf M. Reported burden on informal caregivers of ICU survivors: a literature review. Crit Care. 2016;20:16.
Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med. 2012;40:502–9.
Elliott D, Davidson JE, Harvey MA, Bemis-Dougherty A, Hopkins RO, Iwashyna TJ, et al. Exploring the scope of post-intensive care syndrome therapy and care: engagement of non-critical care providers and survivors in a second stakeholders meeting. Crit Care Med. 2014;42:2518–26.
Henneman EA, Cardin S. Family-centered critical care: a practical approach to making it happen. Crit Care Nurse. 2002;22:12–9.
Quinio P, Savry C, Deghelt A, Guilloux M, Catineau J, de Tinteniac A. A multicenter survey of visiting policies in French intensive care units. Intensive Care Med. 2002;28:1389–94.
Soury-Lavergne A, Hauchard I, Dray S, Baillot ML, Bertholet E, Clabault K, et al. Survey of caregiver opinions on the practicalities of family-centred care in intensive care units. J Clin Nurs. 2012;21:1060–7.
SRLF-SFAR Concensus Conference. Improve living in the intensive care unit. Reanimation. 2009;19:191–203.
Lombardo V, Vinatier I, Baillot ML, Franja V, Bourgeon-Ghittori I, Dray S, et al. How caregivers view patient comfort and what they do to improve it: a French survey. Ann Intensive Care. 2013;3:19.
Berwick DM, Kotagal M. Restricted visiting hours in ICUs: time to change. JAMA. 2004;292:736–7.
Giannini A, Garrouste-Orgeas M, Latour JM. What’s new in ICU visiting policies: can we continue to keep the doors closed? Intensive Care Med. 2014;40:730–3.
Giannini A. Visiting policies and family presence in ICU: a matter for legislation? Intensive Care Med. 2013;39:161.
Giannini A, Miccinesi G, Leoncino S. Visiting policies in Italian intensive care units: a nationwide survey. Intensive Care Med. 2008;34:1256–62.
Giannini A, Miccinesi G, Prandi E, Buzzoni C, Borreani C, OS Group. Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med. 2013;39:2180–7.
Garrouste-Orgeas M, Philippart F, Timsit JF, Diaw F, Willems V, Tabah A, et al. Perceptions of a 24-hour visiting policy in the intensive care unit. Crit Care Med. 2008;36:30–5.
Fumis RR, Ranzani OT, Faria PP, Schettino G. Anxiety, depression, and satisfaction in close relatives of patients in an open visiting policy intensive care unit in Brazil. J Crit Care. 2015;30(440):e441–6.
Ramos FJ, Fumis RR, de Azevedo LC, Schettino G. Intensive care unit visitation policies in Brazil: a multicenter survey. Rev Bras Ter Intensiva. 2014;26:339–46.
Knutsson S, Bergbom I. Nurses’ and physicians’ viewpoints regarding children visiting/not visiting adult ICUs. Nurs Crit Care. 2007;12:64–73.
Hanley JB, Piazza J. A visit to the intensive cares unit: a family-centered culture change to facilitate pediatric visitation in an adult intensive care unit. Crit Care Nurs Q. 2012;35:113–22.
Crider J, Pate MF. Helping children say goodbye to loved ones in adult and pediatric intensive care units: certified child life specialist–critical care nurse partnership. AACN Adv Crit Care. 2011;22:109–12.
Blot F, Foubert A, Kervarrec C, Laversa N, Lemens C, Minet M, et al. Can children visit their relatives in an adult ICU? Bull Cancer. 2007;94:727–33.
Hospitalière SFdH. Recommendations nationale: prévention de la transmission croisée: précaution complémentaire contact. 2009. https://sf2h.net/wp-content/uploads/2009/01/SF2H_prevention-transmission-croisee-2009.pdf.
Garrouste-Orgeas M, Willems V, Timsit JF, Diaw F, Brochon S, Vesin A, et al. Opinions of families, staff, and patients about family participation in care in intensive care units. J Crit Care. 2010;25:634–40.
Tawil I, Brown LH, Comfort D, Crandall CS, West SD, Rollstin AD, et al. Family presence during brain death evaluation: a randomized controlled trial. Crit Care Med. 2014;42:934–42.
Jabre P, Belpomme V, Azoulay E, Jacob L, Bertrand L, Lapostolle F, et al. Family presence during cardiopulmonary resuscitation. N Engl J Med. 2013;368:1008–18.
Warrillow S, Farley KJ, Jones D. Ten practical strategies for effective communication with relatives of ICU patients. Intensive Care Med. 2015;41:2173–6.
Azoulay E, Chaize M, Kentish-Barnes N. Involvement of ICU families in decisions: fine-tuning the partnership. Ann Intensive Care. 2014;4:37.
Warrillow S, Farley KJ, Jones D. How to improve communication quality with patients and relatives in the ICU. Minerva Anestesiol. 2016;82:797–803.
Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, et al. A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med. 2007;356:469–78.
Lautrette A, Ciroldi M, Ksibi H, Azoulay E. End-of-life family conferences: rooted in the evidence. Crit Care Med. 2006;34:S364–72.
Curtis JR, Engelberg RA, Wenrich MD, Nielsen EL, Shannon SE, Treece PD, et al. Studying communication about end-of-life care during the ICU family conference: development of a framework. J Crit Care. 2002;17:147–60.
Garrouste-Orgeas M, Max A, Lerin T, Gregoire C, Ruckly S, Kloeckner M, et al. Impact of proactive nurse participation in ICU family conferences: a mixed-method study. Crit Care Med. 2016;44:1116–28.
Cullinane JP, Plowright CI. Patients’ and relatives’ experiences of transfer from intensive care unit to wards. Nurs Crit Care. 2013;18:289–96.
Clancy O, Edginton T, Casarin A, Vizcaychipi MP. The psychological and neurocognitive consequences of critical illness A pragmatic review of current evidence. J Intensive Care Soc. 2015;16:226–33.
