TY - JOUR
T1 - Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU
AU - Davidson, Judy E.
AU - Aslakson, Rebecca A.
AU - Long, Ann C.
AU - Puntillo, Kathleen A.
AU - Kross, Erin K.
AU - Hart, Joanna
AU - Cox, Christopher E.
AU - Wunsch, Hannah
AU - Wickline, Mary A.
AU - Nunnally, Mark E.
AU - Netzer, Giora
AU - Kentish-Barnes, Nancy
AU - Sprung, Charles L.
AU - Hartog, Christiane S.
AU - Coombs, Maureen
AU - Gerritsen, Rik T.
AU - Hopkins, Ramona O.
AU - Franck, Linda S.
AU - Skrobik, Yoanna
AU - Kon, Alexander A.
AU - Scruth, Elizabeth A.
AU - Harvey, Maurene A.
AU - Lewis-Newby, Mithya
AU - White, Douglas B.
AU - Swoboda, Sandra M.
AU - Cooke, Colin R.
AU - Levy, Mitchell M.
AU - Azoulay, Elie
AU - Curtis, J. Randall
N1 - Publisher Copyright:
© Copyright 2016 by the Society of Critical Care Medicine. All Rights Reserved.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Objective: To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. Methods: We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis, and family-centered care to revise the 2007 Clinical Practice Guidelines for support of the family in the patient-centered ICU. We conducted a scoping review of qualitative research that explored family-centered care in the ICU. Thematic analyses were conducted to support Population, Intervention, Comparison, Outcome question development. Patients and families validated the importance of interventions and outcomes. We then conducted a systematic review using the Grading of Recommendations, Assessment, Development and Evaluations methodology to make recommendations for practice. Recommendations were subjected to electronic voting with pre-established voting thresholds. No industry funding was associated with the guideline development. Results: The scoping review yielded 683 qualitative studies; 228 were used for thematic analysis and Population, Intervention, Comparison, Outcome question development. The systematic review search yielded 4,158 reports after deduplication and 76 additional studies were added from alerts and hand searches; 238 studies met inclusion criteria. We made 23 recommendations from moderate, low, and very low level of evidence on the topics of: communication with family members, family presence, family support, consultations and ICU team members, and operational and environmental issues. We provide recommendations for future research and work-tools to support translation of the recommendations into practice. Conclusions: These guidelines identify the evidence base for best practices for family-centered care in the ICU. All recommendations were weak, highlighting the relative nascency of this field of research and the importance of future research to identify the most effective interventions to improve this important aspect of ICU care.
AB - Objective: To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. Methods: We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis, and family-centered care to revise the 2007 Clinical Practice Guidelines for support of the family in the patient-centered ICU. We conducted a scoping review of qualitative research that explored family-centered care in the ICU. Thematic analyses were conducted to support Population, Intervention, Comparison, Outcome question development. Patients and families validated the importance of interventions and outcomes. We then conducted a systematic review using the Grading of Recommendations, Assessment, Development and Evaluations methodology to make recommendations for practice. Recommendations were subjected to electronic voting with pre-established voting thresholds. No industry funding was associated with the guideline development. Results: The scoping review yielded 683 qualitative studies; 228 were used for thematic analysis and Population, Intervention, Comparison, Outcome question development. The systematic review search yielded 4,158 reports after deduplication and 76 additional studies were added from alerts and hand searches; 238 studies met inclusion criteria. We made 23 recommendations from moderate, low, and very low level of evidence on the topics of: communication with family members, family presence, family support, consultations and ICU team members, and operational and environmental issues. We provide recommendations for future research and work-tools to support translation of the recommendations into practice. Conclusions: These guidelines identify the evidence base for best practices for family-centered care in the ICU. All recommendations were weak, highlighting the relative nascency of this field of research and the importance of future research to identify the most effective interventions to improve this important aspect of ICU care.
KW - critical care
KW - critical care nursing
KW - family
KW - intensive care
KW - intensive care
KW - neonatal
KW - patient-centered care
UR - http://www.scopus.com/inward/record.url?scp=85006409343&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85006409343&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000002169
DO - 10.1097/CCM.0000000000002169
M3 - Article
C2 - 27984278
AN - SCOPUS:85006409343
VL - 45
SP - 103
EP - 128
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 1
ER -