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Palliation of Thirst in Intensive Care Unit Patients: Translating Research Into Practice
Ann Leemhuis1, Yuriko Shichishima1, Kathleen Puntillo2
1Ann Leemhuis is clinical nurse III, adult medical-surgical intensive care unit, University of California San Francisco Medical Center, San Francisco, California. Yuriko Shichishima is a clinical nurse II and a clinical nurse educator, Department of Community Health Systems, School of Nursing, University of California San Francisco Medical Center. Kathleen Puntillo is professor emeritus, Department of Physiological Nursing, University of California San Francisco School of Nursing.
Background:
Thirst is prevalent among patients in intensive care units. A research-based "thirst bundle" was shown to significantly decrease thirst in these patients.
Objective:
To implement a research-based thirst intervention performed by intensive care unit nurses and patients' family members.
Methods:
Nurses and family members were taught the thirst intervention through video training and project team reinforcement. The intervention was performed by nurses for 123 patients and by family members for 13 patients. Thirst was measured with a numeric rating scale of 0 to 10, a word scale of 0 to 3, or "yes/no" answers, whichever was easiest for the patient. Inferential statistics were used to assess changes in thirst scores over time. Also assessed were nurse and family member burden levels, family level of satisfaction, and patient enjoyment.
Results:
Thirst scores on the numeric rating scale decreased significantly: from a mean (SD) of 7.9 (2.0) before to 3.9 (2.7) after the intervention for nurses (P < .001); and from 9.2 (1.5) to 5.3 (2.6) for family members (n = 13; P = .002). Word scale scores also decreased significantly, from a median (interquartile range) of 3 (3-3) before to 2 (1-2) after the intervention for nurses (P < .001). Most patients (96%) reported enjoying the procedure. Median burden levels were less than 2 on a numeric rating scale of 0 to 10.
Conclusions:
The palliative "thirst bundle" significantly alleviated patients' thirst and resulted in little caregiver burden. Further efforts are warranted to incorporate this intervention into intensive care unit practice.
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