Family Engagement During Patient- and Family-Centered Interdisciplinary Rounds in the Adult Intensive Care Unit
Bibliographic record
Abstract
BACKGROUND: Family engagement in interdisciplinary rounds is a patient- and family-centered approach to critical care that allows family members to be present and participate in information sharing and clinical decision-making with the health care team. However, this approach has not been adopted as standard practice in adult critical care units. Thus, family engagement in care for critically ill patients remains an inconsistent practice. Moreover, it remains an underresearched family-centered care intervention. Research is needed to understand health care professionals' perspectives on feasible ways of integrating family inclusion and engagement into clinical practice flow to potentially shape the future of family engagement in care for critically ill patients. OBJECTIVES: This qualitative exploratory research study aimed to (1) explore and understand the registered nurses' and physicians' perspectives on current practices and feasible approaches to family inclusion and engagement during patient- and family-centered interdisciplinary rounds and (2) identify the facilitators and barriers to implementing this vital practice. METHODS: A qualitative exploratory research study was conducted to inform the main study, a randomized controlled trial that tested the impact of the Nurse-TECH-Family program during patient- and family-centered interdisciplinary rounds in the intensive care unit. For this focus group study, 7 health care providers working in an adult critical care unit were recruited via email, referrals, and personal contact. The focus group included 4 registered nurses and 3 physicians working in the intensive care unit. It was conducted using structured questions via videoconferencing. The discussions were recorded and transcribed verbatim. A rigorous data analysis method was conducted using Braun and Clarke's constructionist and contextualist approach for thematic analysis. FINDINGS: Two essential themes that reflected health care providers' perspectives on current critical care practice and feasible ways of integrating family inclusion and engagement into clinical practice were illuminated. The first theme conveys that rounds are "information-giving" that addresses family members' questions, transparency, shared decision-making, and less uncertainty among family members. The second theme denotes that rounds are a "safe space" for caring and compassion, which helps build trust. The health care providers also identified that the barriers to family engagement in patient- and family-centered interdisciplinary rounds include diverse perceptions and practices of family inclusion and engagement during rounds, difficulty establishing logistics in integrating family engagement in interdisciplinary rounds to clinical practice, and anxiety related to disclosure of information and uncertainty about family response. The identified facilitators are clear, consistent, realistic, and feasible interdisciplinary rounds logistics and information. DISCUSSION: This qualitative exploratory research study provided a deeper understanding of the registered nurses' and physicians' perspectives on current practices and feasible ways regarding family engagement during patient- and family-centered interdisciplinary and identified barriers to and facilitators for implementing this vital practice. The study's findings informed the researchers in the sampling, design, and plan for the intervention and setting for the randomized controlled trial. The findings can pave the way for a more focused, multifaceted approach and interventions to address family inclusion and engagement during interdisciplinary rounds in the critical care unit. This offers hope for improved patient outcomes and family experiences.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".