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Implementation of a Nurse-Led Family Meeting in a Neuroscience Intensive Care Unit
Huixin Wu1, Dianxu Ren, Glenn R Zinsmeister
1Huixin Wu, DNP, RN, CCRN, CCNS, is assistant professor, Department of Nursing, Chatham University, Pittsburgh, Pennsylvania. She also works as a clinical research coordinator in a Magnet designated hospital. She has over 20 years of critical care nursing experience. Her teaching experience includes instructing undergraduate and graduate nursing students. Dianxu Ren, PhD, MD, is associate professor and associate director for statistical support, University of Pittsburgh, Pennsylvania. His area of research is biostatistics including longitudinal data analysis, measurement error and missing data problems, Bayesian analysis and statistical computation. He has 9 years of experience at the University of Pittsburgh School of Nursing. Glenn R. Zinsmeister, MSN, RN, is clinical director of Neuroscience ICU, Surgical ICU, and a Neuro step down unit, UPMC Shadyside Hospital, Pittsburgh, Pennsylvania. He also serves as an Adjunct Clinical instructor at Carlow University, Pittsburgh, Pennsylvania. He has 30 years of nursing experience. Gretchen E. Zewe, PhD, RN, is assistant professor, University of Pittsburgh, Pennsylvania. Her primary teaching responsibility focuses on the senior medical-surgical course and senior seminar. She also serves on doctoral committees for both PhD and DNP students. Her clinical expertise is in the field of neurology. Patricia K. Tuite, PhD, RN, CCNS, is assistant professor and coordinator of the clinical nurse specialist area of concentration, University of Pittsburgh, Pennsylvania. She is currently the coordinator for the Medical-Surgical Clinical Nurse Specialist Area of Concentration. She teaches at the undergraduate and graduate levels.
Purpose/Objectives:
The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members.
Background:
Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses.
Methods:
This quality improvement project was implemented in a 10-bed neuroscience ICU over a 3-month period. A convenience sample of 23 nurses participated in the project. Following development of a communication protocol to facilitate nurse-led meetings, the nurses received education and then implemented the protocol. Thirty-one family members participated in the project. Family members were surveyed before and after the meetings.
Results:
Mean meeting time was 26 (SD, 14) minutes. Following implementation of the meetings, findings demonstrated that families felt that communication improved (P = .02 and P = .008), they had appropriate information for decision making allowing them to feel in control (P = .002), and there was an increase in family satisfaction (P = .001).
Conclusion:
Early ICU nurse-led family meetings were feasible, improved communication between ICU nurses and family members, facilitated decision making in ICU families, and increased satisfaction of family members.
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