Making changes to improve the intensive care unit experience for patients and their families

With the technology explosion and scientific advances in the field of critical care in the past three decades came an era in which ICUs were referred to as an arena for punitive survivalists. Although clinicians have developed an increased ability to improve the quality and quantity of life for patients in the long term post discharge, patients and their families often suffered more than is necessary in the short term, during the critical care phase of the illness. It is well documented that physiologic and psychologic stress impacts negatively on both short-term and long-term patient outcomes. In the last 10 yrs, the attention of individual caregivers, units, organizations, and researchers has turned to improving the ICU experience for patients and families. This article reviews the relevant literature and also reports the experience of those who have created and applied unique strategies that address the patient and family needs, thus promoting their comfort and relieving their distress. Although more outcome studies are needed in this area of care, applying some of the lessons already learned can significantly improve the ICU experience for most patients and families.