Abstract
BackgroundThe 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.MethodsWe 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.ResultsAmong 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.ConclusionsAlthough 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0185-x) contains supplementary material, which is available to authorized users.
Highlights
Introduction of a central venous catheterOrotracheal intubation Bronchoscopy Tracheal aspiration Echocardiography Other types of echography Insertion of a gastric tube Insertion of a pleural tube Cardiac arrest Ward rounds Nursing care respecting the need of privacy 186 (98.9)Data are expressed as numbers (%) 2 (1.0)most frequently allowed to be present were tracheal aspiration (36/188, 19.1 %), nursing care respecting the need of privacy (51/188, 27.1 %), and rounds with the staff (18/188, 9.6 %)
The key findings are that 23.9 % of intensive care unit (ICU) applied unrestricted visiting policies; that children were accepted without any barrier of age in 59.1 % of ICUs; that information was delivered to family through structured family meetings on admission in 79.2 % of ICUs and with the participation of nurses in almost 70 % of them
Information delivered to the family was reported in the patient chart by only 111/188 ICUs (59 %)
Summary
Introduction of a central venous catheterOrotracheal intubation Bronchoscopy Tracheal aspiration Echocardiography Other types of echography Insertion of a gastric tube Insertion of a pleural tube Cardiac arrest Ward rounds Nursing care respecting the need of privacy 186 (98.9)Data are expressed as numbers (%) 2 (1.0)most frequently allowed to be present were tracheal aspiration (36/188, 19.1 %), nursing care respecting the need of privacy (51/188, 27.1 %), and rounds with the staff (18/188, 9.6 %). 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. Families of intensive care patients expressed psychological distress during the ICU stay of their relatives. Having a loved one dying in ICU can be responsible of complicated grief in 52 % of the relatives [6] or of heavy burden [7] The importance of such consequences has been recently described under the term of post-intensive care syndrome-family [8, 9]. Numerous approaches have been described to limit these consequences on families’ members, such as the development of family-centered care, including revised visiting policies and modalities of information [10]
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