Abstract

PURPOSE: The aim of this qualitative study was to explore whether families who attended rounds in the adult intensive care unit (ICU) understood the daily plan of care. National ICU societies support family attendance at ICU-rounds so families are fully informed.(Allum et al., 2022; Au et al., 2021; Calderone et al., 2022) Family satisfaction imay increase by attending rounds.(Blakeney et al., 2023; Debay et al., 2023) Yet little is known about how families use the information they hear.

PARTICIPANTS: Family surrogate decision makers were invited. The setting was a medical-surgical ICU in a university-affiliated hospital in the United States. Local ethics approval was obtained. Before rounds, all participants signed a consent form.

METHODS: Family members were interviewed in a private conference room using a semi-structured interview guide. Both ICU rounds and interviews were audio-recorded and transcribed verbatim. Transcripts were reviewed for accuracy and analyzed by two investigators to identify major themes.

RESULTS: Twenty–three family members (19 families) were interviewed. A comparison of recorded ICU-rounds transcripts, and interview transcripts demonstrated that families accurately understood the ICU plan of care. Two salient themes emerged.

Theme 1: Family Comprehension. Families' understanding improved with repeated daily attendance at ICU rounds. Three distinct phases were identified (1) Shock (first attendance); (2) Deciphering Medical Jargon (attended several times); (3) Listening for changes (attended many times). Medical terminology was an initial barrier to comprehension. A simplified summary at the end of rounds helped families comprehend the plan.

Theme 2: Communication Responsibilities. Family members described a responsibility to communicate daily updates to a wider family and friend network. Summaries were composed and distributed by phone, email, or group-text immediately after rounds. Close family members received detailed texts, and the extended network received an overview. These communication tasks were not disclosed to nurses and physicians. This intra-family communication role has not previously been described in the literature.

IMPLICATIONS FOR PRACTICE: It is essential when family members attend rounds, that a brief, simple summary of the daily plan of care be provided at the end. This summary helps family members understand the ICU plan and ensures accurate dissemination to their extended family network.

Notes

References: Abu-Rish Blakeney, E., Baird, J., Beaird, G., Khan, A., Parente, V. M., O'Brien, K. D., Zierler, B. K., O'Leary, K. J., & Weiner, B. J. (2023). How and why might interprofessional patient- and family-centered rounds improve outcomes among healthcare teams and hospitalized patients? A conceptual framework informed by scoping and narrative literature review methods. Frontiers in medicine, 10, 1275480. https://doi.org/10.3389/fmed.2023.1275480

Allum, L., Apps, C., Pattison, N., Connolly, B., & Rose, L. (2022). Informing the standardising of care for prolonged stay patients in the intensive care unit: A scoping review of quality improvement tools. Intensive & Critical Care Nursing, 73, 103302. https://doi.org/10.1016/j.iccn.2022.103302

Au, S. S., Roze des Ordons, A. L., Blades, K. G., & Stelfox, H. T. (2021). Best practices toolkit for family participation in ICU rounds. Journal of Evaluation in Clinical Practice, 27(5), 1066–1075. https://doi.org/10.1111/jep.13517

Calderone, A., Debay, V., & Goldfarb, M. J. (2022). Family Presence on Rounds in Adult Critical Care: A Scoping Review. Critical Care Explorations, 4(11), e0787. https://doi.org/10.1097/CCE.0000000000000787

Debay, V., Hallot, S., Calderone, A., & Goldfarb, M. (2023). Family Participation in Cardiovascular Intensive Care Unit Rounds: A Pilot Randomized Controlled Trial. CJC Open, 5(8), 619–625. https://doi.org/10.1016/j.cjco.2023.05.002

Description

This qualitative research study explores families' understanding of the plan of care after attending rounds in the adult intensive care unit.

Author Details

Mary E. Lough PhD, RN and Linda Ottoboni PhD, RN

Sigma Membership

Alpha Alpha Lambda at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Qualitative Research

Keywords:

Acute Care, Rounding, Intensive Care

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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Family Understanding of Intensive Care Unit Rounds: A Qualitative Research Study

Seattle, Washington, USA

PURPOSE: The aim of this qualitative study was to explore whether families who attended rounds in the adult intensive care unit (ICU) understood the daily plan of care. National ICU societies support family attendance at ICU-rounds so families are fully informed.(Allum et al., 2022; Au et al., 2021; Calderone et al., 2022) Family satisfaction imay increase by attending rounds.(Blakeney et al., 2023; Debay et al., 2023) Yet little is known about how families use the information they hear.

PARTICIPANTS: Family surrogate decision makers were invited. The setting was a medical-surgical ICU in a university-affiliated hospital in the United States. Local ethics approval was obtained. Before rounds, all participants signed a consent form.

METHODS: Family members were interviewed in a private conference room using a semi-structured interview guide. Both ICU rounds and interviews were audio-recorded and transcribed verbatim. Transcripts were reviewed for accuracy and analyzed by two investigators to identify major themes.

RESULTS: Twenty–three family members (19 families) were interviewed. A comparison of recorded ICU-rounds transcripts, and interview transcripts demonstrated that families accurately understood the ICU plan of care. Two salient themes emerged.

Theme 1: Family Comprehension. Families' understanding improved with repeated daily attendance at ICU rounds. Three distinct phases were identified (1) Shock (first attendance); (2) Deciphering Medical Jargon (attended several times); (3) Listening for changes (attended many times). Medical terminology was an initial barrier to comprehension. A simplified summary at the end of rounds helped families comprehend the plan.

Theme 2: Communication Responsibilities. Family members described a responsibility to communicate daily updates to a wider family and friend network. Summaries were composed and distributed by phone, email, or group-text immediately after rounds. Close family members received detailed texts, and the extended network received an overview. These communication tasks were not disclosed to nurses and physicians. This intra-family communication role has not previously been described in the literature.

IMPLICATIONS FOR PRACTICE: It is essential when family members attend rounds, that a brief, simple summary of the daily plan of care be provided at the end. This summary helps family members understand the ICU plan and ensures accurate dissemination to their extended family network.