Doing time in an Australian ICU; the experience and environment from the perspective of patients and family members

被引:22
作者
Tronstad, Oystein [1 ,2 ,3 ]
Flaws, Dylan [1 ,4 ,5 ]
Lye, India [1 ,6 ]
Fraser, John F. [1 ,2 ]
Patterson, Sue [1 ,7 ]
机构
[1] Prince Charles Hosp, Adult Intens Care Serv, Crit Care Res Grp, Brisbane, Qld, Australia
[2] Univ Queensland, Fac Med, Brisbane, Qld, Australia
[3] Prince Charles Hosp, Physiotherapy Dept, Brisbane, Qld, Australia
[4] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia
[5] Queensland Univ Technol, Sch Clin Sci, Brisbane, Qld, Australia
[6] Griffith Univ, Menzies Hlth Inst QLD, Gold Coast, Qld, Australia
[7] Univ Queensland, Sch Dent, Brisbane, Qld, Australia
关键词
Delirium; Environment; ICU redesign; Ideal ICU; Light; Noise; Patient experience; Patient interviews; Patient outcomes; Personalised care; MECHANICALLY VENTILATED PATIENTS; INTENSIVE-CARE; RISK-FACTORS; DELIRIUM; OUTCOMES; GUIDELINES; IMPACT; SLEEP; NOISE;
D O I
10.1016/j.aucc.2020.06.006
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: The intensive care environment and experiences during admission can negatively impact patient and family outcomes and can complicate recovery both in hospital and after discharge. While their perspectives based on intimate experiences of the environment could help inform design improvements, patients and their families are typically not involved in design processes. Rather than designing the environment around the needs of the patients, emphasis has traditionally been placed on clinical and economic efficiencies. Objective: The main objective was to inform design of an optimised intensive care bedspace by developing an understanding of how patients and their families experience the intensive care environment and its impact on recovery. Methods: A qualitative descriptive study was conducted with data collected in interviews with 17 intensive care patients and seven family members at a large cardiothoracic specialist hospital, analysed using a framework approach. Results: Participants described the intensive care as a noisy, bright, confronting and scary environment that prevented sleep and was suboptimal for recovery. Bedspaces were described as small and cluttered, with limited access to natural light or cognitive stimulation. The limited ability to personalise the environment and maintain connections with family and the outside world was considered especially problematic. Conclusions: Intensive care patients described features of the current environment they considered problematic and potentially hindering their recovery. The perspective of patients and their families can be utilised by researchers and developers to improve the design and function of the intensive care environment. This can potentially improve patient outcomes and help deliver more personalised and effective care to this vulnerable patient population and their families. (c)& nbsp;2020 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:254 / 262
页数:9
相关论文
共 65 条
[1]   Effect of intensive care unit environment on in-hospital delirium after cardiac surgery [J].
Arenson, Benjamin G. ;
MacDonald, Lindsey A. ;
Grocott, Hilary P. ;
Hiebert, Brett M. ;
Arora, Rakesh C. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2013, 146 (01) :172-178
[2]  
Australian Institute of Health and Welfare, 2019, ADM PAT CAR 2017 18
[3]   Potential use of melatonin in sleep and delirium in the critically ill [J].
Bellapart, J. ;
Boots, R. .
BRITISH JOURNAL OF ANAESTHESIA, 2012, 108 (04) :572-580
[4]  
Bion Victoria, 2018, J Intensive Care Soc, V19, P138, DOI 10.1177/1751143717740803
[5]   The effect of light on critical illness [J].
Castro, Ricardo ;
Angus, Derek C. ;
Rosengart, Matt R. .
CRITICAL CARE, 2011, 15 (02)
[6]   The impacts of the built environment on health outcomes [J].
Codinhoto, Ricardo ;
Tzortzopoulos, Patricia ;
Kagioglou, Mike ;
Aouad, Ghassan ;
Cooper, Rachel .
FACILITIES, 2009, 27 (3-4) :138-151
[7]  
Corrigan Ingrid, 2007, Intensive Crit Care Nurs, V23, P206, DOI 10.1016/j.iccn.2007.01.004
[8]   Looking for light in the din: An examination of the circadian-disrupting properties of a medical intensive care unit [J].
Danielson, Samantha J. ;
Rappaport, Charles A. ;
Loher, Michael K. ;
Gehlbach, Brian K. .
INTENSIVE AND CRITICAL CARE NURSING, 2018, 46 :57-63
[9]   Mapping sources of noise in an intensive care unit [J].
Darbyshire, J. L. ;
Mueller-Trapet, M. ;
Cheer, J. ;
Fazi, F. M. ;
Young, J. D. .
ANAESTHESIA, 2019, 74 (08) :1018-1025
[10]   "I Can Remember Sort of Vivid People ... but to Me They Were Plasticine." Delusions on the Intensive Care Unit: What Do Patients Think Is Going On? [J].
Darbyshire, Julie L. ;
Greig, Paul R. ;
Vollam, Sarah ;
Young, J. Duncan ;
Hinton, Lisa .
PLOS ONE, 2016, 11 (04)