A tailored multicomponent program to reduce discomfort in critically ill patients: a cluster-randomized controlled...

Area of Science:

• Critical care medicine
• Patient experience
• Quality improvement in healthcare

Background:

• Critically ill patients face significant stress and discomfort during intensive care unit (ICU) stays.
• Existing ICU protocols may not adequately address patient-reported discomfort.

Purpose of the Study:

• To evaluate the effectiveness of a tailored multicomponent program in reducing self-perceived discomfort among critically ill adult patients.
• To assess the impact of a structured intervention on patient well-being in the ICU setting.

Main Methods:

• A cluster-randomized trial involving 34 French ICUs, with a 6-month intervention period and a crossover design.
• The intervention included patient discomfort assessment, regular feedback to healthcare teams, and site-specific tailored interventions.
• The primary outcome was measured using the 16-item Intensive and Prolonged Respiratory Events Assessment (IPREA) questionnaire.

Main Results:

• The tailored program resulted in a significant reduction in the overall discomfort score (difference of -7.00; p < 0.001).
• Adjusted analysis confirmed the program's positive effect, with a -6.35 difference in overall discomfort (p < 0.001).
• Twelve out of 16 individual discomfort items measured by the IPREA questionnaire showed significant improvement.

Conclusions:

• A tailored multicomponent program effectively decreases self-perceived discomfort in critically ill adult patients.
• The findings support the implementation of such programs to enhance patient care and experience in ICUs.