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Institute for Implementation Science in Health Care

Family engagement in intensive care units

10-countries-study published

10 Länder Studie

Families often do not receive sufficient opportunities to be involved in the care of their close others being treated in intensive care units (ICUs), even though we know that family engagement has positive effects on patient recovery and well-being.

This study examined the manner in which nurses engage families of critically ill patients in 10 countries to determine what is needed to increase active family partnerships ICUs.

An international team of nurse researchers from five continents examined how nurses engage families in ICUs. The qualitative study, which included 65 nurses from 26 ICUs worldwide, shows that nurse-family engagement is a complex and fluctuating process that needs to be carefully negotiated and balanced. Nurses often hold more decision-making power than families. Family engagement was subject to wide variations and depended on the individual nurse, teams, and day-to-day activities. Many factors shaped engagement, such as team culture, collaborative relationships, unit structures and organizational resources. Many similarities and few differences were found across cultures, but there was a clear influence of the context of care in each ICU.

This international study highlights strengths and weaknesses in the current adoption of proactive family engagement in ICUs. It provides an empirical basis for taking concrete actions aimed at improving family participation in ICUs. For example, a supportive organizational environment and focused teamwork are needed to develop a shared culture of family engagement that consistently meets families' needs for inclusion in care. Interprofessional team-based implementation and improvement strategies, such as the creation of evidence-based guidelines and policies and collaborative educational opportunities, are essential to advancing the culture of family engagement and support in critical care.

The study was conducted as part of the International Family Nursing Association (IFNA) Research Clusters in Family Care in Acute and Critical Illness, of which Professor Rahel Naef is co-chair.

Original study Link

IFNA blog on the study Link