Society of Critical Care Medicine Guidelines on Family-Centered Care for Adult ICUs: 2024

被引：1

作者：

Hwang, David Y. ^{[1
]}

Oczkowski, Simon J. W. ^{[2
]}

Lewis, Kimberley ^{[2
]}

Birriel, Barbara ^{[3
]}

Downar, James ^{[4
]}

Farrier, Christian E. ^{[5
,6
]}

Fiest, Kirsten M. ^{[6
]}

Gerritsen, Rik T. ^{[7
]}

Hart, Joanna ^{[8
]}

Hartog, Christiane S. ^{[9
,10
]}

Heras-La Calle, Gabriel ^{[11
]}

Hope, Aluko A. ^{[12
]}

Jennerich, Ann L. ^{[13
]}

Kentish-Barnes, Nancy ^{[14
]}

Kleinpell, Ruth ^{[15
]}

Kross, Erin K. ^{[13
]}

Marshall, Andrea P. ^{[16
,17
]}

Nydahl, Peter ^{[18
,19
]}

Peters, Theodora

Rosa, Regis G. ^{[20
]}

Scruth, Elizabeth ^{[21
]}

Sederstrom, Nneka ^{[22
]}

Stollings, Joanna L. ^{[15
]}

Turnbull, Alison E. ^{[23
]}

Valley, Thomas S. ^{[24
,25
]}

Netzer, Giora ^{[26
]}

Aslakson, Rebecca A. ^{[27
]}

Hopkins, Ramona O. ^{[28
]}

机构：

[1] Univ North Carolina Chapel Hill, Carrboro, NC 27599 USA

[2] McMaster Univ, Hamilton, ON, Canada

[3] Penn State Univ, University Pk, PA USA

[4] Univ Ottawa, Ottawa, ON, Canada

[5] Univ Oxford, Oxford, England

[6] Univ Calgary, Calgary, AB, Canada

[7] Med Ctr Leeuwarden, Leeuwarden, Netherlands

[8] Univ Penn, Philadelphia, PA USA

[9] Charite, Berlin, Germany

[10] Klin Bavaria Kreischa, D-01731 Kreischa, Germany

[11] Int Res Project Humanizat Intens Care Units Proyec, Madrid, Spain

[12] Oregon Hlth & Sci Univ, Portland, OR USA

[13] Univ Washington, Seattle, WA USA

[14] St Louis Hosp, AP HP Nord, Paris, France

[15] Vanderbilt Univ, Nashville, TN USA

[16] Gold Coast Hlth, Southport, Qld, Australia

[17] Griffith Univ, Southport, Qld, Australia

[18] Univ Hosp Schleswig Holstein, Kiel, Germany

[19] Paracelsus Med Univ, Salzburg, Austria

[20] Hosp Moinhos Vento, Porto Alegre, Brazil

[21] Kaiser Permanente Hlth Plan & Hosp Northern Calif, Oakland, CA USA

[22] Hennepin Healthcare, Minneapolis, MN USA

[23] Johns Hopkins Univ, Baltimore, MD USA

[24] Univ Michigan, Ann Arbor, MI USA

[25] Ann Arbor Vet Affairs Ctr, Ann Arbor, MI USA

[26] Univ Maryland, Baltimore, MD USA

[27] Univ Vermont, Burlington, VT USA

[28] Brigham Young Univ, Provo, UT USA

来源：

CRITICAL CARE MEDICINE | 2025年 / 53卷 / 02期

关键词：

communication training; evidence-based medicine; family engagement; family support; Grading of Recommendations; Assessment; Development; and Evaluation criteria; guidelines; staff support; surrogate decision-making; SURROGATE DECISION-MAKERS; POSTTRAUMATIC-STRESS-DISORDER; CHRONIC CRITICAL ILLNESS; OF-LIFE DECISION; WEB-BASED TOOL; INTENSIVE-CARE; ILL PATIENTS; COMMUNICATION-SKILLS; RANDOMIZED-TRIAL; QUALITY IMPROVEMENT;

D O I：

10.1097/CCM.0000000000006549

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

RATIONALE:For staff in adult ICUs, providing family-centered care is an essential skill that affects important outcomes for both patients and families. The COVID-19 pandemic placed unprecedented strain on care of ICU families, and practices for family engagement and support are still adjusting.OBJECTIVES:To review updated evidence for family support in adult ICUs, provide clear recommendations, and spotlight optimal family-centered care practices post-pandemic.PANEL DESIGN:The multiprofessional guideline panel of 28 individuals, including family member partners, applied the processes described in the Society of Critical Care Medicine Standard Operating Procedures Manual to develop and publish evidence-based recommendations in alignment with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Conflict-of-interest policies were strictly followed in all phases of the guidelines, including panel selection, writing, and voting.METHODS:The guidelines consist of four content sections: engagement of families, support of family needs, communication support, and support of ICU clinicians providing family-centered care. We conducted systematic reviews for 15 Population, Intervention, Control, and Outcomes questions, organized among these content sections, to identify the best available evidence. We summarized and assessed the certainty of evidence using the GRADE approach. We used the GRADE evidence-to-decision framework to formulate recommendations as strong or conditional, or as best practice statements where appropriate. The recommendations were approved using an online vote requiring greater than 80% agreement of voting panel members to pass.RESULTS:Our panel issued 17 statements related to optimal family-centered care in adult ICUs, including one strong recommendation, 14 conditional recommendations, and two best practice statements. We reaffirmed the critical importance of liberalized family presence policies as default practice when possible and suggested options for family attendance on rounds and participation in bedside care. We suggested that ICUs provide support for families in the form of educational programs; ICU diaries; and mental health, bereavement, and spiritual support. We suggested the importance of providing structured communication for families and communication training for clinicians but did not recommend for or against any specific clinician-facing tools for family support or decision aids, based on current available evidence. We recommended that adult ICUs implement practices to systematically identify and reduce barriers to equitable critical care delivery for families and suggested that programs designed to support the wellbeing of clinicians responsible for family support be developed.CONCLUSIONS:Our guideline panel achieved consensus regarding recommendations and best practices for family-centered care in adult ICUs.

引用

页码：e465 / e482

页数：18

共 138 条

[1] Hume N.E., Zerfas I., Wong A., Et al., Clinical impact of the implementation strategies used to apply the 2013 pain, agitation/ sedation, delirium or 2018 pain, agitation/sedation, delirium, immobility, sleep disruption guideline recommendations: A systematic review and meta-analysis, Crit Care Med, 52, pp. 626-636, (2024)
[2] Alspach J.G., Overlooking an integral lynchpin of patient care: The caregiver at home, Crit Care Nurse, 38, pp. 10-15, (2018)
[3] Zante B., Camenisch S.A., Schefold J.C., Interventions in post-intensive care syndrome-family: A systematic literature review, Crit Care Med, 48, pp. e835-e840, (2020)
[4] Davidson J.E., Powers K., Hedayat K.M., Et al., Society of Critical Care Medicine: Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine task force 2004-2005, Crit Care Med, 35, pp. 605-622, (2007)
[5] Davidson J.E., Aslakson R.A., Long A.C., Et al., Guidelines for family-centered care in the neonatal, pediatric, and adult ICU, Crit Care Med, 45, pp. 103-128, (2017)
[6] Kleinpell R., Zimmerman J., Vermoch K.L., Et al., Promoting family engagement in the ICU: Experience from a national collaborative of 63 ICUs, Crit Care Med, 47, pp. 1692-1698, (2019)
[7] Hwang D.Y., Zhang Q., Andrews A., Et al., The initial impact of the coronavirus disease 2019 pandemic on ICU family engagement: Lessons learned from a collaborative of 27 ICUs, Crit Care Explor, 3, (2021)
[8] Roger C., Ling L., Petrier M., Et al., Occurrences of posttraumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: The international PSY-CO in ICU study, Ann Gen Psychiatry, 23, (2024)
[9] Guyatt G.H., Oxman A.D., Kunz R., Et al., GRADE guidelines: 2. Framing the question and deciding on important outcomes, J Clin Epidemiol, 64, pp. 395-400, (2011)
[10] Higgins J.P.T.T., Chandler J., Cumpston M., Et al., Cochrane Handbook for Systematic Reviews of Interventions, (2019)

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