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Patient and FamilyCentered ActionableProcesses of Care andPerformance Measuresfor Persistent andChronic CriticalIllness: A SystematicReview Louise RoseLaura IstanboulianLaura Allum2019 год

Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
review

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Аннотация: To identify actionable processes of care, quality indicators, or performance measures and their evidence base relevant to patients with persistent or chronic critical illness and their family members including themes relating to patient/family experience.Two authors independently searched electronic, systemic review, and trial registration databases (inception to November 2016).We included studies with an ICU length of stay of greater than or equal to 7 days as an inclusion criterion and reported actionable processes of care; quality improvement indicators, measures, or tools; or patient/family experience. We excluded case series/reports of less than 10 patients.Paired authors independently extracted data and performed risk of bias assessment.We screened 13,130 references identifying 114 primary studies and 102 relevant reviews. Primary studies reported data on 24,252 participants; median (interquartile range) sample size of 70 (32-182). We identified 42 distinct actionable processes of care, the most commonly investigated related to categories of 1) weaning methods (21 studies; 27 reviews); 2) rehabilitation, mobilization, and physiotherapy (20 studies; 40 reviews); and 3) provision of information, prognosis, and family communication (14 studies; 11 reviews). Processes with limited evidence were generally more patient-centered categories such as communication, promotion of sleep, symptom management, or family support. Of the 21 randomized controlled trials, only two were considered at low risk of bias across all six domains, whereas just two cohort studies and one qualitative study were considered of high quality.We identified 42 distinct actionable processes of care relevant to patients with persistent or chronic critical illness and their families, with most frequently studied processes relating to weaning, rehabilitation/mobilization, and family communication. Qualitative studies highlighted the need to address psychologic needs and distressing symptoms as well as enabling patient communication. Our findings are informative for clinicians and decision-makers when planning high-quality patient and family-focused care.
Год издания: 2019
Авторы: Louise Rose, Laura Istanboulian, Laura Allum, Lisa Burry, Craig Dale, Nicholas Hart, Kalliopi Kydonaki, Pam Ramsay, Natalie Pattison, Bronwen Connolly
Издательство: Wolters Kluwer
Источник: Critical Care Explorations
Ключевые слова: Family and Patient Care in Intensive Care Units, Palliative Care and End-of-Life Issues, Intensive Care Unit Cognitive Disorders
Другие ссылки: Critical Care Explorations (HTML)
DOAJ (DOAJ: Directory of Open Access Journals) (HTML)
www.criticalcareontario.ca (PDF)
journals.lww.com (HTML)
Europe PMC (PubMed Central) (PDF)
Europe PMC (PubMed Central) (HTML)
University of Hertfordshire Research Archive (University of Hertfordshire) (PDF)
University of Hertfordshire Research Archive (University of Hertfordshire) (HTML)
Discovery Research Portal (University of Dundee) (PDF)
Discovery Research Portal (University of Dundee) (HTML)
Discovery Research Portal (University of Dundee) (HTML)
PubMed Central (HTML)
Edinburgh Napier Research Repository (Edinburgh Napier University) (HTML)
PubMed (HTML)