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      Family Presence on Rounds : A Systematic Review of Literature

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          Abstract

          Family-centered care has become the new trend in the health care field that involves honoring the patient and families' perspectives and choices and supporting them in participating in care and decision making at whatever level they choose. Family presence on rounds is one of the guidelines instituted for evidence-based best practices for support of family in the delivery of patient-centered care in the intensive care unit (ICU) but identified as the least studied among all the other aspects of family-centered care in the ICU. From 1988 to 2010, only 1 research study on family presence was conducted in an adult ICU. The purpose of this article was to review research studies related to family presence on medical rounds; reviews that focus on both adults and pediatric patients in the critical and noncritical care settings are also included.

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          Using qualitative research.

          Margarete Sandelowski (2004)
          A renewed urgency has emerged in the qualitative health research community concerning the utility of qualitative research. This urgency is the result of several converging trends in health care research, including the elevation of practical over basic knowledge, proliferation of qualitative health research studies, and the rise of evidence-based practice as a paradigm and methodology for health care. Diverse conceptualizations of use and users exist, and these have different implications for understanding, demonstrating, and enhancing the utility of qualitative research findings. Issues affecting the utilization of these findings include the varied ways in which they are conceived, presented, synthesized, signified, and translated, and the complex repertoire of skills required to activate the knowledge transformation cycle in qualitative health research fully.
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            Family-centered care and the pediatrician's role.

            (2003)
            Drawing on several decades of work with families, pediatricians, other health care professionals, and policy makers, the American Academy of Pediatrics provides a definition of family-centered care. In pediatrics, family-centered care is based on the understanding that the family is the child's primary source of strength and support. Further, this approach to care recognizes that the perspectives and information provided by families, children, and young adults are important in clinical decision making. This policy statement outlines the core principles of family-centered care, summarizes the recent literature linking family-centered care to improved health outcomes, and lists various other benefits to be expected when engaging in family-centered pediatric practice. The statement concludes with specific recommendations for how pediatricians can integrate family-centered care in hospitals, clinics, and community settings as well as in more broad systems of care.
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              Communication in critical care: family rounds in the intensive care unit.

              Robert Mulder, Natalie Jacobowski, Timothy Girard … (2010)
              Communication with family members of patients in intensive care units is challenging and fraught with dissatisfaction. We hypothesized that family attendance at structured interdisciplinary family rounds would enhance communication and facilitate end-of-life planning (when appropriate). The study was conducted in the 26-bed medical intensive care unit of a tertiary care, academic medical center from April through October 2006. Starting in July 2006, families were invited to attend daily interdisciplinary rounds where the medical team discussed the plan for care. Family members were surveyed at least 1 month after the patient's stay in the unit, completing the validated "Family Satisfaction in the ICU" tool before and after implementation of family rounds. Of 227 patients enrolled, 187 patients survived and 40 died. Among families of survivors, participation in family rounds was associated with higher family satisfaction regarding frequency of communication with physicians (P = .004) and support during decision making (P = .005). Participation decreased satisfaction regarding time for decision making (P = .02). Overall satisfaction scores did not differ between families who attended rounds and families who did not. For families of patients who died, participation in family rounds did not significantly change satisfaction. In the context of this pilot study of family rounds, certain elements of satisfaction were improved, but not overall satisfaction. The findings indicate that structured interdisciplinary family rounds can improve some families' satisfaction, whereas some families feel rushed to make decisions. More work is needed to optimize communication between staff in the intensive care unit and patients' families, families' comprehension, and the effects on staff workload.
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                Author and article information

                Journal
                Title: Dimensions of Critical Care Nursing
                Abbreviated Title: Dimensions of Critical Care Nursing
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 0730-4625
                Publication date Created: 2012
                Publication date (Print): 2012
                Volume: 31
                Issue: 1
                Pages: 53-64
                Article
                DOI: 10.1097/DCC.0b013e31824246dd
                PubMed ID: 22156815
                SO-VID: 0c7757e6-287f-4fd4-86c3-23af0a3aa37d
                Copyright © © 2012
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