Family-centered Care Interventions Research Articles

Factors influencing the development and implementation of pediatrics in family-centered care model: A scoping review

Introduction: Family-Centered Care (FCC) in neonatal healthcare emphasizes collaborative efforts between medical staff and families. This approach, rooted in mutual respect and active family participation, aims to enhance infant care outcomes. However, understanding the underlying forces behind FCC interventions remains challenging due to the diverse methods employed in healthcare practices. Methods: We conducted a scoping review in June 2023. We searched Embase, Medline, CINAHL, Web of Science, Cochrane Library, Joanna Briggs Institute (JBI), PubMed, and PsycINFO. Inclusion criteria encompassed English language studies on Family-centered care and related factors, without date or geographic restrictions. Results: Fifteen pertinent studies meeting the inclusion criteria were identified. Five pivotal components of modern FCC emerged: effective communication, active patient and family involvement, robust family support systems, organizational considerations, and the nurturing attitude of nurses. Discussion: Family-centered care emerges as a comprehensive healthcare approach focusing on the interdependence of patients, healthcare professionals, and families. By recognizing this interconnection, FCC seeks to ensure the satisfaction and well-being of all stakeholders. Implementing FCC strategies presents challenges, emphasizing the need for continuous exploration and refinement. Conclusion: Embracing family-centered care principles enriches patient-centered healthcare by involving families as active partners in the care process. Acknowledging the integral role of families enhances care quality and contributes to improved patient outcomes. Ongoing research and dialogue are essential for refining FCC models, ensuring successful implementation, and fostering patient-centered healthcare environments.

An exploration of the cultural appropriateness of the family-centered function-focused care intervention.

The Family-centered Function Focused Care (Fam-FFC) intervention, is a nurse-family care partnership model aimed to improve the physical and cognitive recovery in hospitalized persons living with Alzheimer's Disease Related Dementias (ADRD) while improving the care partner's experiences. Discussions of patients' needs and preferences between nurses and the patient's close family members have been found to be useful in preventing excessive stress in persons with dementia, while lessening the anxiety of care partners. However, the efficacy of dementia-specific interventions is influenced in part by the degree to which the interventions are flexible and sensitive to the patient's and care-partner's condition, needs, and preferences, including cultural preferences. Therefore, the purpose of this study is to assess the cultural appropriateness of Fam-FFC using the Ecological Validity Model (EVM). This qualitative, descriptive study included 28 consented care partners drawn from a sample of 455 dyads enrolled in the Fam-FFC intervention. An interview guide was created based on the EVM. Participants provided demographic data. Thematic analysis was conducted to analyze transcribed interviews. The majority of the sample was female (79%), Non-Hispanic (96%) and half were married. One-half of the sample represented Black care partners and one-half were White. Seventy-nine percent lived with their family member with ADRD. Three major themes were identified from the thematic analysis including Care Partner Identity, Care Partner Preferences, and Goals of Care for functional recovery of their family member living with dementia. In this study care partners wanted more social services as well as home care that supported not just physical needs but also social and recreational needs. Findings from the study offer guidance on improving the Fam-FFC intervention including strengthening education and resources on partner self-care.

The moderating effects of nurses' background characteristics on the relationship between family-centred care perception and practice for hospitalized children and their families in Malawi

PurposeGlobally, limited information is available on the relationship between the perception and practice of family-centered care (FCC), and the moderating effects of nurses' background characteristics on this relationship. This study investigated the relationship between FCC perception and FCC practice and the moderating effects of the nurses' background characteristics on this relationship. Design and methodsA cross-sectional study was conducted using a two-stage stratified sampling method. Data were collected from 444 nurses using the Family Centered Care Questionnaire-Revised and analyzed using IBM SPSS Version 25. The Hayes PROCESS macro model, version 3, was integrated into SPSS to examine the moderating effects at a significance level of 0.05. ResultsThe response rate was 98%, and a statistically significant positive association was found between FCC perception and FCC practice (r = 0.353, p < .001). Gender of a nurse (ΔR2 = 0.0206, p < .002), having children (ΔR2 = 0.0231, p < .001), experience (ΔR2 = 0.0107, p = .028), and working in a medical–surgical ward (ΔR2 = 0.0208, p = .008) had a statistically significant moderating effect on the relationship between FCC perception and FCC practice. ConclusionThese findings provide minimal evidence of the existence of non-modifiable moderators of FCC. Future studies with modifiable moderators are therefore needed. Practice implications: Understanding the moderating effects of nurses' background characteristics on the relationship between FCC perception and FCC practice may facilitate the development of FCC interventions that favor these background characteristics and facilitate the integration of FCC into routine policies and practices.

Application of Trauma-Informed Care Principles to Care Needs Identified by Mothers of NICU-Hospitalized Children

Systematic uptake of family-centered care (FCC) interventions remains challenging and frequently suboptimal in many neonatal intensive care units (NICUs). Across NICUs in the United States, integrating family members as partners in infant caregiving and decision-making has not been well supported and routine screening and provision of psychological support for parents remains inadequate. Trauma-informed care (TIC) may offer a more comprehensive approach to NICU care which can encompass FCC principles and promote family recovery and resilience by recognizing and responding to the traumas experienced by NICU infants and families. The current paper aimed to understand needs identified by mothers of NICU-hospitalized children and reports a focused analysis of one-on-one interview data (n = 13 mothers) collected during a larger mixed methods study. Reflexive thematic analysis was used to understand needs identified by mothers and to explore how these needs aligned with TIC principles. Six themes were identified and subsequently examined in the context of the principles of TIC: I Just Had No Control, That Really Caught Us Off Guard, So Much Was Already Taken Away, We’re People and There Needs To Be More Support and Practices Which Helped. Mothers’ care needs were found to align with TIC principles. Findings suggest that implementation of TIC principles in NICU settings can support parental presence, participation in infant care, and mental health and support the potential of TIC as a more comprehensive approach to meeting the needs of NICU parents.

Multidimensional assessment of infant, parent and staff outcomes during a family centered care enhancement project in a tertiary neonatal intensive care unit: study protocol of a longitudinal cohort study

BackgroundThe therapeutic advances and progress in the care for preterm infants have enabled the regular survival of very immature infants. However, the high burden of lifelong sequelae following premature delivery constitutes an ongoing challenge. Regardless of premature delivery, parental mental health and a healthy parent–child relationship were identified as essential prerogatives for normal infant development. Family centered care (FCC) supports preterm infants and their families by respecting the particular developmental, social and emotional needs in the Neonatal Intensive Care Unit. Due to the large variations in concepts and goals of different FCC initiatives, scientific data on the benefits of FCC for the infant and family outcome are sparse and its effects on the clinical team need to be elaborated.MethodsThis prospective single centre longitudinal cohort study enrols preterm infants ≤ 32 + 0 weeks of gestation and/or birthweight ≤ 1500 g and their parents at the neonatal department of the Giessen University Hospital, Giessen, Germany. Following a baseline period, the rollout of additional FCC elements is executed following a stepwise 6-months approach that covers the NICU environment, staff training, parental education and psychosocial support for parents. Recruitment is scheduled over a 5.5. year period from October 2020 to March 2026. The primary outcome is corrected gestational age at discharge. Secondary infant outcomes include neonatal morbidities, growth, and psychomotor development up to 24 months. Parental outcome measures are directed towards parental skills and satisfaction, parent-infant-interaction and mental health. Staff issues are elaborated with particular focus on the item workplace satisfaction. Quality improvement steps are monitored using the Plan- Do- Study- Act cycle method and outcome measures cover the infant, the parents and the medical team. The parallel data collection enables to study the interrelation between these three important areas of research. Sample size calculation was based on the primary outcome.DiscussionIt is scientifically impossible to allocate improvements in outcome measures to individual enhancement steps of FCC that constitutes a continuous change in NICU culture and attitudes covering diverse areas of change. Therefore, our trial is designed to allocate childhood, parental and staff outcome measures during the stepwise changes introduced by a FCC intervention program.Trial registrationClinicaltrials.gov, trial registration number NCT05286983, date of registration 03/18/2022, retrospectively registered, http://clinicaltrials.gov.

Effect of family-centered care interventions on well-being of caregivers of children with cerebral palsy: a systematic review

Background: Caring for a child with long-term functional limitations can have a negative impact on the physical and psychological well-being of the caregiver. Family-centered care (FCC) interventions have the potential to empower caregivers and contribute to their well-being. This systematic review aimed to synthesize existing evidence on the effectiveness of FCC interventions in improving the well-being of caregivers of children with cerebral palsy (CP), and identify the key components of such interventions that are most commonly practiced and deemed effective. Methods: This review systematically searched seven databases for randomized controlled trials that evaluated the effectiveness of any FCC intervention on the well-being of caregivers of children with or at risk of CP. We used the Cochrane RoB 2.0 tool to assess risk of bias and Critical Appraisal Skills Programme (CASP) checklist for critical appraisal. Due to high heterogeneity of studies, narrative synthesis was used to summarize the data. Results: The review consists of 11 studies which were categorized into five sections based on the components of FCC intervention provided in each individual study: 1. Information provision, and Enabling and partnership (n= 5); 2. Information provision, and Respectful and supportive care (n= 1); 3. Enabling and partnership (n= 2); 4. Enabling and partnership, and Respectful and supportive care (n= 2); 5. Information provision, Enabling and partnership and Respectful and supportive care (n= 1). Risk of bias was low in four studies, unclear in two studies, and high in five studies. Conclusion: FCC interventions were found to be effective in improving caregivers’ satisfaction with attainment of child and caregiver goals. Evidence from multiple studies does not strongly support the effectiveness of FCC interventions on caregiver’s mental health, parenting and personal outcomes. Limited evidence precludes a conclusion on the effectiveness of the components of FCC on well-being of caregivers of children with CP.

Developing a Burn-Specific Family-Centered Care (BS-FCC) Framework: A Multi-Method Study

A burn has been described as a family injury warranting the delivery of family-centered care (FCC) across the continuum of burns management. This assertion notwithstanding, only limited progress has been made to develop and implement FCC interventions in the burn unit. As a starting point, this study sought to formulate a tentative framework to underpin FCC in burn care. A multi-method design comprising an umbrella review and the secondary data analysis of qualitative datasets was employed. Following these, the findings were merged and aligned to the Universal Model of FCC to formulate the burn-specific FCC framework. For the umbrella review, four review articles met the criteria for inclusion. Following a data synthesis of the review findings and their integration with the qualitative dataset, four meta-themes that encapsulate the shared needs/concerns of family members of both pediatric and adult burn survivors emerged: (1) psychosocial concerns, (2) issues relating to role changes, (3) logistical concerns, and (4) requiring information. These issues were mapped to the following components of the Universal Model of FCC: family support, education, collaboration, and communication. All these are underpinned by dedicated policies, procedures, and consideration of the family context. Testing and further empirical work are needed to refine and implement the framework across the continuum of burn management.

Treatment Fidelity of the Family-Centered Function-Focused Care Intervention.

The purpose of the current study was to evaluate treatment fidelity (i.e., the extent to which an intervention is provided as intended) in the Family-Centered Function-Focused Care (Fam-FFC) intervention. This was a descriptive study using data collected during intervention activities throughout the course of the Fam-FFC study. Specific measures included Environment and Policy Assessments, Fam-FFC Knowledge Test, Goal Attainment Scale, Function-Focused Care Behavior Checklist, and completion of the FamPath Audit. Delivery was provided as intended. Staff demonstrated intervention skills with only one Fam-FFC research nurse needing retraining. Receipt was based on Fam-FFC Knowledge Test scores >80%, with the majority of participants reporting goal achievement as expected or higher than expected and slight improvement in environments and policies to better support Fam-FFC. Lastly, enactment was based on evidence that in 67% of observations staff provided at least one function-focused care intervention. Findings from this study will be used to adapt the intervention to reach all staff, increase ways to change environments and policies, consider ways to more comprehensively evaluate enactment of function-focused care during real-world interactions, and consider the characteristics of nursing staff and whether a relationship exists between staff characteristics and providing function-focused care. [Research in Gerontological Nursing, 16(4), 165-171.].

Validation of post-traumatic growth inventory in mothers with the experience of having the NICU-Hospitalized newborns "validation of post-traumatic growth inventory".

Investigating post-traumatic growth (PTG) in mothers with the experience of having a preterm newborn hospitalized in the NICU requires a valid tool. This study aims to determine the validity and reliability of the Farsi version of the post-traumatic growth inventory (PTGI) in mothers with the experience of having their newborns hospitalized in the NICU. This study was methodological research. In this study, 250 mothers who had newborns with a history of NICU hospitalization during the last 3 to 12 months and had visited paediatric clinics of the selected hospitals in Tehran with the aim of having their children's condition examined were selected through convenience sampling. The data were collected using a demographic information questionnaire and PTGI. The face validity, the construct validity (confirmatory factor analysis), and the internal consistency reliability of the inventory were measured using SPSS V22 and LISREL V8.8. According to appropriate values for factor analysis fit indices (FI = 0.94, RMSEA = 0.07, IFI = 0.94, NFI = 0.93, RFI = 0.91, NNFI = 0.93, SRMR = 0.07), 21 items and 5 factors were confirmed for this inventory. Furthermore, Cronbach's alpha coefficient of this inventory was measured as α = 0.94. According to favourable psychometric properties, the Farsi version of PTGI is a suitable tool for studying PTG in mothers with the experience of having preterm newborns in the NICU. Using PTGI can help nurses in planning family-centered care interventions to reduce the impact of the mental trauma caused by the preterm newborn's hospitalization in parents. Mothers who had newborns with a history of NICU hospitalization during the last 3-12 months.

Effects of Patient and Family-Centered Care on Quality of Care in Pediatric Patients: A Systematic Review

Background: Patient and family-centered care is one approach that is applied in pediatric care in various hospital settings to improve the quality of care. However, information related to the results of the entire study and its intervention model has not been identified effectively in child health care.Purpose: This study aimed to describe and assess the effects of patient and family-centered care on the quality of care in pediatric patients.Methods: A systematic review was used as a method in this study. Seven databases were used, including ScienceDirect, Scopus, ProQuest, EBSCO, Sage Journal, Tailor and Francis, and PubMed to search the literature for relevant published reviews that determined patient and family-centered care interventions between 2011 and 2021. The synthesis without meta-analysis guidelines was used to analyze the data in this review. The data were further analyzed by critically assessing the quality of the articles using the JBI and CASP checklists.Results: From a total of 29.780 articles identified, fifteen articles were included in this review. Several models of patient and family-centered care interventions were identified, such as family-centered care, family-centered communication program, family-integrated care, family nurture intervention, family empowerment, parent participation, close collaboration, mother-nurse partnership program, and the newborn individualized developmental care and assessment program. From those models, the outcomes for quality of care were related to the pediatric quality of life, length of stay, patient safety, parent satisfaction, parent psychological response, and parent involvement and partnership with staff.Conclusion: The shreds of evidence indicate that patient and family-centered care can improve the quality of care in the pediatric patients. It is recommended that patient and family-centered care can be implemented in pediatric care by increasing the participation of family during treatment.

Family-centred interventions for Indigenous early childhood well-being by primary healthcare services.

Family-centred interventions for Indigenous early childhood well-being by primary healthcare services.

"I Didn't Sign Up for This": Perspectives from Persons Living with Dementia and Care Partners on Challenges, Supports, and Opportunities to Add Geriatric Neuropalliative Care to Dementia Specialty Care.

In the United States, dementia specialty centers affiliated with centers of excellence for research hold promise as locations to develop innovative, holistic care in care systems otherwise siloed by discipline or payer. We conducted foundational research to inform development of patient-and family-centered palliative care interventions for dementia specialty centers. We interviewed persons living with dementia (PLWD), current, and former care partners (CP) recruited from a specialty dementia clinic and purposively selected for variation across disease syndrome and stage. A framework method of thematic analysis included coding, analytic matrices, and pattern mapping. 40 participants included 9 PLWD, 16 current CPs, and 15 former CPs of decedents; 48% impacted by Alzheimer's disease dementia. While help from family, support groups and adult day centers, paid caregiving, and sensitive clinical care were invaluable to PLWD, CPs, or both, these supports were insufficient to navigate the extensive challenges. Disease-oriented sources of distress included symptoms, functional impairment and falls, uncertainty and loss, and inaccessible care. Social and relational challenges included constrained personal and professional opportunities. The obligation and toll of giving or receiving caregiving were challenging. Clinical care challenges for PLWD and/or CPs included care fragmentation, insufficient guidance to inform planning and need for expert interdisciplinary clinical care at home. Findings highlight the breadth and gravity of gaps, which surpass the disciplinary focus of either behavioral neurology or palliative care alone. Results can inform the development of novel interventions to add principles of geriatrics and neuropalliative care to dementia care.

Understanding and Enhancing Occupational Therapists' Use of Standard Family-Centered Measures.

The use of standard family-centered measures (FCMs) is imperative to guide family-centered care (FCC) interventions and monitor their outcomes. To measure the frequency of FCM use and evaluate the effectiveness of experiential learning and reflection to increase their use. Descriptive and two-group pre-post comparative training study. Continuing education center. Phase 1 included 145 health care providers. Phase 2 included 44 school-based occupational therapists who participated in Phase 1. Phase 2 participants enrolled in 30-hr FCC training that included a 2-hr workshop on FCM. One group (n = 22) conducted an FCM with a family and wrote a reflective report. All participants completed the Measure of Processes of Care-Service Provider (MPOC-SP) questionnaire and reported how frequently they used FCMs. FCM use rates were low (50%, not at all; 26%, to a very small extent). The extent of FCC was correlated with FCM use (r = .24-.30, p < .01). A Wilcoxon signed-rank test demonstrated that participants who administered an FCM with a family and reflected on this experience showed significant increases (Z = 176.0, p = .001) in FCM use compared with participants who were only instructed about available FCM. A Mann-Whitney U test confirmed the difference (U = 3.54, p = .012). FCM use is sparse, but experiential and reflective activities are simple keys to promoting FCC and integrating FCM into practice. What This Article Adds: Training designers, educators, and managers should consider integrating experiential learning to enhance providers' expertise and quality of care.

Missed Caregiving: A Call to Action for Health System Leadership.

Five years ago, we wrote an editorial about the goals of individualized developmental care and the implementation challenges neonatal intensive care units (NICUs) face even when established care guidelines exist, in light of the fact that the evidence for many interventions were still lacking.1 Existing barriers included healthcare system structures that did not support delivery of developmentally focused care. For example, despite the knowledge that high noise levels are stressful for both infants and parents, many alarm systems do not inform caregivers without also creating significant noise. Since that first editorial, significant empirical evidence highlights the value of integrated family-centered developmental care interventions for both high-risk infants and their familes2–4; yet, NICUs continue to struggle to fully implement this important care. For example, evidence of the importance of zero separation of infants from their families now exists.2,4 Currently, the lack of full implementation of integrated family-centered developmental care is frequently blamed on the COVID-19 pandemic.5–8 At the height of the pandemic, parent access to the NICU was significantly limited. Yet, even today parental presence in the NICU is limited by nursery policies, COVID-19 quarantine protocols, and structural determinants such as lack of access to affordable transportation. Parents may need to care for other children who are not able to attend school or day care because of COVID-19 exposures or illness. Even when parent presence in the NICU is unhindered by COVID-19, they may not be able to afford to be with their infant as frequently or as long as they would prefer because of their job requirements or transportation costs. In addition, the COVID-19 pandemic has led to nurse burnout, stress, and staff shortages.9,10 Short-staffed NICUs create morale distress for nurses who cannot deliver the high quality of care they know the infants and families deserve.11 Regardless, even when parents are present in the nursery, staff may not have the time to support parents' informational, emotional, and physical needs. The term “missed care” is often used to refer to care that is not, but should be, delivered. Missed care in the NICU often includes the provision of integrated family-centered care and was present prior to the pandemic12 and is related to nurse job enjoyment and their plans to leave the NICU.13 To ensure nurses can deliver the care they know is essential for the infants and families, hospital health systems must support workload assessment that includes these important aspects of caregiving.14 Every neonatal nurse knows that it takes more time to teach and support a parent to provide caregiving to perform that caregiving themselves. Yet, parental presence and participation in the health care decision making and delivery of care are essential to parental confidence in their caregiving and decreasing infant hospital stay. Parents must be acknowledged as an important aspect of the caregiving team, potentially the most important aspect, given their long-term impact on the growth and development of the infant. Over the past 2 years, we have all seen the power of the voice of nurses. It is now time to raise our voices for ourselves and the infants and families we serve. We must advocate at the national level for standardized staffing levels that allow for the appropriated delivery of care and polices that ensure that parental presence is not compromised on the basis of racial and structural determinants of health. While zero separation may seem like an unreasonable and unobtainable goal, if we don't have such a goal we will not begin to move the needle toward a more optimal setting that supports the growth and development of infants and their families. Therefore, given the importance of the provision of integrated family-centered care, nurses must be afforded the time to ensure they can have effective interactions with families, deliver developmental interventions and parent teaching, and maintain ongoing relationships with families over the course of the hospital stay. —Debra Brandon, PhD, RN, CCNS, FAAN Co-Editor; Advances in Neonatal Care [email protected] —Jacqueline M. McGrath, PhD, RN, FNAP, FAAN Co-Editor; Advances in Neonatal Care [email protected]

Effect of family-centred care on parental mental health and parent–infant interactions for preterm infants: a systematic review protocol

IntroductionUnexpected premature delivery and separation from preterm infants are common problems that parents of preterm infants must handle with. Parents of preterm infants may suffer from severe psychological distress. Family-centred...

Integrative Review for a Family-centered Care Intervention to Promote Family Functioning in Families Living with Children with Chronic Illness

Integrative Review for a Family-centered Care Intervention to Promote Family Functioning in Families Living with Children with Chronic Illness

Development of a Family-Centred Nutrition and Exercise Diabetes Care Programme for Better Diabetes Outcomes in Rural Areas of Limpopo: Practice-Oriented Theory

Background: Cost-effective interventions are required to manage the increasing prevalence of diabetes mellitus and minimize new cases. Family-centred care interventions positively influence patients’ diabetes outcomes and improve health and quality of life. This article aims to describe the development of family-centred nutrition and exercise diabetes care intervention. Methods: A mixed method study design was used in the baseline study. The findings from the qualitative interviews and quantitative survey informed the development of the family-centred nutrition and exercise diabetes programme, with the guidance of practice-oriented theory. Results: Components of practice-oriented theory guided the study and were applied. The researcher outlined that dietitians and physiotherapists are agents to provide family-centred nutrition and exercise diabetes care to patients and their families. One element of practice-oriented theory involves how the programme is to be implemented, which will be face-to-face in focus groups. Conclusion: The study further highlights the need for piloting the implementation of the intervention to determine other dynamics that may obstruct overall implementation.

The impact of family-centered care interventions on neonatal and parental outcomes in a Turkish hospital

AimThis study aimed to improve nurses’ attitudes towards parental engagement and to examine the impact of implementing nursing interventions related to family-centred care on neonatal and parental outcomes in a university hospital in Turkey. MethodsA quasi-experimental, nonequivalent, and post-test research design was used. Using convenience sampling, the study was completed with 128 preterm infants and their parents, including 64 in the experimental group and 64 in the control group at a neonatal intensive care unit of a university hospital. The control group data were collected from medical records and parents before practising family-centred nursing interventions developed for the experimental group. In addition, nurses were given a four hour training session aimed to improve their attitudes towards parental participation in care, with the nurses’ attitudes measured before, immediately after, and one month after the training. The experimental group data were collected from medical records and parents after 10 nursing interventions based on family-centred care supported by managers began to be implemented by trained nurses in the neonatal intensive care unit. The Parent-Preterm Infant Characteristics Form, Maternal Attachment Inventory, Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N), and Parental Engagement Attitude Scale were used for the data collection. FindingsWhile nurses’ scores of attitudes toward parental participation obtained immediately after and one month after the training were higher than those before the training, the scores one month after were lower compared to those immediately after. The results indicated that discharge weight gain of infants in the experimental group were significantly higher than those in the control group and that there was no significant difference between the groups in length of stay at neonatal intensive care unit. The maternal attachment and satisfaction scores of the parents in the experimental group were significantly higher than those in the control group. ConclusionImplementing family-centred nursing care interventions, developed based on unit needs and supported by managers, with trained neonatal intensive care nurses positively impacted parent-infant attachment, parent satisfaction, and infant weight gain.

The effect of an ICU liaison nurse-led family-centred transition intervention program in an adult ICU.

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. To develop and implement a patient- and family-centered transitional care intervention plan for patients transferred to the ICU. Prospective, pretest and posttest design. 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). 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). 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. 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.

Clinical Pearls

Almost one-third of deaths in the United States take place in intensive care units. Critical care health providers report high levels of stress and burnout when working with end-of-life (EOL) care. Although various EOL care interventions have been developed, little evidence is available on their use in practice.Palma and colleagues conducted focus groups with physicians, nurses, and nursing assistants in Chile to explore their perceptions of EOL care. The major themes include The findings show the need for interprofessional collaborative strategies to support all critical care staff. The authors suggest communication training to build care providers’ confidence in EOL care.See Article, pp 24-32. Delirium affects up to 80% of all patients in intensive care units (ICUs). This costly complication (&gt;$182 billion nationally) has been associated with long-term cognitive and functional deterioration. Standardized screening tools, such as the Confusion Assessment Method for the ICU (CAM-ICU), are widely used in practice by highly trained delirium experts and ICU providers. However, when used by bedside practitioners, the sensitivity of the tool for detecting delirium drops significantly.Sinvani and colleagues explored the feasibility of using a telehealth training program with a remotely located delirium specialist. They found Although further research is needed to examine the impact of telehealth on patient outcomes, the authors suggest use of tele-ICU platforms to share expertise from one remote location to numerous other sites.See Article, pp 73-76. Visitation of family members during the COVID-19 pandemic was not permitted in most hospitals, greatly affecting communication between the patient’s provider and the surrogate decision maker (SDM). Although many intensive care units instituted a daily telephone call between a senior physician and the SDM to provide patient-related information, perceptions of this practice are unknown.Fritz and colleagues surveyed SDMs, physicians, family members, and other health care providers to assess their experience with this practice. They found The practice was satisfactory for most physicians and SDMs; however, the authors suggest improvement with more frequent calls and use of videoconferencing.See Article, pp 77-81. Infants born with a congenital heart defect (CHD) are at risk for neurodevelopmental abnormalities such as cognitive disabilities, mental health problems, and gross motor deficits. Individualized family-centered developmental care (IFDC) interventions such as cue-based care and parent participation have been successfully used with premature infants to prevent neurodevelopmental problems; however, the practice with infants with a CHD varies.LaRonde and colleagues surveyed nurses from 25 cardiovascular programs to describe the current state of IFDC practice. They found Although most respondents described competence with IFDC, practice varied widely. The authors state that next steps should include development of guidelines for infants with CHD and then implementation and evaluation across pediatric critical care settings.See Article, pp e10-e19.