Nurse to Family Communication in Intensive Care Units

Abstract

Nurse to family communication is a crucial aspect of high-quality care delivery in adult intensive care units (ICU). Adult ICU nurses hold a unique position to engage in meaningful communication with families, often being the most accessible healthcare team members to family. However, these nurses frequently express a sense of ineptitude in their nurse to family communication skills. Simultaneously, families often find themselves unprepared for these adult ICU interactions yet are regularly tasked with the responsibility of surrogate decision-making when patients are incapacitated. Despite the successful utilization of the COMFORT (Connect, Options, Making meaning, Family caregivers, Openings, Relating, and Team) communication intervention in other settings, its implementation in the adult ICU has not been realized. Exploring the perspectives of adult nurses and nurse leaders on the COMFORT intervention topics could enhance the success of its implementation and sustainability in clinical practice. The overall goal of this three-paper dissertation was to advance scientific knowledge about nurse to family communication in the adult ICU setting. An integrative review was conducted to systematically assess available research evidence on enhancing communication between adult ICU patients/families and nurses. Using qualitative focus group approach, the aims of the next two studies were to gather participants’ perspectives of the practicability, appeal, and relevance of each COMFORT communication intervention topics and strategies for its implementation among adult ICU nurse leaders (second paper) and ICU nurses (third paper). Results of these studies indicate the importance of nurse to family communication in adult ICU environments and nurse leaders’ and nurses’ enthusiasm for the implementation of the COMFORT intervention in the ICU setting. Recommendations emerging from the focus group interviews include providing adult ICU nurses dedicated time to complete training during work hours, allowing early adopters to use the COMFORT app before expanding it to the entire unit staff nurse population, making the app accessible on unit computers, providing training suitable for nurses at all experience levels (from early career to seasoned staff), adopting a phased approach to implementation, and offering education on the COMFORT topics in quick, digestible learning tools suitable for a fast-paced nursing unit.