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A Quality Improvement Project to Support Post-Intensive Care Unit Patients with COVID-19: Structured Telephone

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Summary

Structured telephone support (STS) helped identify post-intensive care syndrome (PICS) symptoms in patients and families after COVID-19 hospitalization. Early support improved individualized care plans and addressed early PICS symptoms.

Keywords:
COVID-19evidence-based quality improvementsfamily-centered careintensive care unitnurse-led

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Area of Science:

  • Intensive Care Medicine
  • Quality Improvement Science
  • Public Health

Background:

  • Over 50% of intensive care unit (ICU) survivors experience long-term physical, psychosocial, and cognitive impairments, known as post-intensive care syndrome (PICS).
  • The COVID-19 pandemic heightened stress and uncertainty for ICU patients and families, increasing fears of PICS development without adequate aftercare.
  • This study aimed to identify PICS symptoms and support patients/families during the transition from hospital to home.

Purpose of the Study:

  • To identify post-intensive care syndrome (PICS) symptoms in patients and their families.
  • To provide structured telephone support (STS) to aid the transition from hospital to home.
  • To improve individualized care plans and optimize follow-up for early PICS symptoms.

Main Methods:

  • A quality improvement study conducted during the COVID-19 pandemic.
  • Development and implementation of a tool to structure telephone calls for PICS symptom identification and support.
  • Support provided to COVID-19 pneumonia patients and their family caregivers within four weeks of hospital discharge.

Main Results:

  • Forty-six post-ICU patients reported PICS symptoms, with over half experiencing fatigue and loss of strength.
  • Cognitive and psychological impairments were less frequently reported by patients.
  • Family caregivers reported fewer issues but desired continuity of care, informing ICU nurse practitioners for care plan optimization.

Conclusions:

  • The STS tool provided valuable insights into post-ICU patient impairments.
  • Family caregivers reported fewer impairments than anticipated.
  • Early, structured support post-discharge can guide individualized care plans and manage early PICS symptoms.