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Using an intervention mapping approach to develop a discharge protocol for intensive care patients.

Margo van Mol1, Marjan Nijkamp2, Christine Markham3

  • 1Department of Intensive Care Adults, Erasmus MC University Medical Center, P.O. Box 2040, Room 1005, 3000, CA, Rotterdam, The Netherlands. m.vanmol@erasmusmc.nl.

BMC Health Services Research
|December 21, 2017
PubMed
Summary

Developing an intervention to improve intensive care unit (ICU) discharge, this study used Intervention Mapping to create a practical discharge protocol. The goal is to support patients and families facing long-term consequences after critical illness.

Keywords:
Discharge protocolEmotional distressHealth service researchIntensive care unitIntervention mappingTransition procedure

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Area of Science:

  • Critical Care Medicine
  • Health Services Research
  • Patient Transition

Background:

  • Intensive care unit (ICU) admission can lead to lasting physical, cognitive, and emotional effects for patients and families.
  • Continuity of care post-ICU discharge is crucial for patient well-being.
  • This study focused on developing an intervention to address the need for integrated care during ward transition.

Purpose of the Study:

  • To describe the development of an intervention aimed at improving the ICU discharge process.
  • To create a theory- and evidence-based discharge protocol for better patient outcomes.

Main Methods:

  • Intervention Mapping (IM), a six-step approach, guided the development process.
  • Included literature review, interviews with former ICU patients and relatives, and qualitative meetings with nurses.
  • Formulated objectives and selected theory-based methods to address identified barriers to effective discharge.

Main Results:

  • Former patients and relatives emphasized the need for clear discharge information and written materials.
  • Nurses identified benefits and barriers related to discharge procedures, with some skepticism from ICU nurses regarding lay summaries.
  • The developed intervention targets patient and nurse knowledge, attitudes, self-efficacy, and social influence.

Conclusions:

  • Intervention Mapping provided a robust framework for developing an improved ICU discharge protocol.
  • The resulting protocol is theory- and empirically-based, designed for relevance and feasibility in daily practice.