Knowledge, perceptions and experiences of nurses towards family centred care in adult intensive care units

Abstract

Aim and objectives: To explore and describe the knowledge, perceptions and experiences of nurses towards family centered care in adult ICUs. Background: Promoting quality patient care and family satisfaction is a current trend in health care systems. In addition, the identification of family needs has been used as a means to measure quality patient care in intensive care units (ICUs). Evidence shows that family centred care (FCC) is an essential approach to promote quality patient care through the recognition of family needs. Admission to an ICU creates increased stress levels for the patient and family members, thus nurses’ knowledge, skills and experiences are crucial during this time of a family crisis. Nurses in ICU are in the best position as critical bedside nurses to assess and evaluate strategies that can be used to minimise and prevent stressors that are caused by the critical illnesses and the ICU environment. Design: An exploratory descriptive qualitative design was used.

Method: The study was conducted in a district and academic tertiary public hospital based in KwaZulu Natal. This hospital provides health care services to a diverse and cross cultural population. Two ICUs were used for data collection, namely, a surgical and a medical ICU. Nine nurses were purposively recruited from the two adult intensive care units. Data was collected using in-depth interviews with the assistance of an interview guide and audio recording. Qualitative content analysis was used to analyse the data. Results: Findings of this study indicated that nurses have an accurate and correct knowledge on the concept of FCC, thus identifying and recognising their roles and responsibilities with respect to the components that enhance FCC. However their perceptions towards facilitating family involvement in nursing care activities as part of FCC, revealed discrepancies due to mentioned factors that cause a hindrance in family involvement. Participants’ experiences has been shown to be positive in relation to family presence in ICUs, however findings indicated that participants restricted family visitation in adult ICUs is based on the existing policy pertaining to

family visitation in ICUs. Consequently, nurses noted the great contribution a family makes towards patients’ well being in an ICU. Conclusion: The study findings showed that nurses in the selected ICUs require skills and training on the strategies that can be used to enhance and promote active family involvement in relation to nursing care activities in adult ICUs. Relevance to clinical practice: Training and further research for nurses has been proposed so as to better equip and encourage nurses with the necessary knowledge and skills required to improve family nursing in adult ICUs. In addition, the ICU environment including management, infrastructure and policy development can be adopted to allow such changes. Hence, nurses would need guidelines to be able to practice evidence based practices.