Nurses’ Experience of Family-Centered Rounds in the Intensive Care Unit
Bibliographic record
Abstract
A paradigm shift in the Canadian healthcare system has transitioned the patient and family from care recipients to integral and valued members of the multidisciplinary team. Implementation of family-centered care within the context of the adult Intensive Care Unit (ICU) remains slow to adopt in Canada despite evidence that open visitation and family presence offer many benefits to improve the delivery of quality care, and satisfaction with the overall patient experience. The COVID-19 pandemic has further complicated the ability of the healthcare team to effectively include patients and families into their daily multidisciplinary rounds. Restricted visitation policies, infection control and social distancing concerns, physician variability, and a healthcare staffing crisis are among a few barriers to practice that hinder the ability to reintegrate families into a process that was once successful pre-pandemic. This qualitative study uses a phenomenological approach guided by the philosophical underpinnings of Maurice Merleau-Ponty to describe frontline ICU nurses’ lived experience of family-centered rounds. Eight ICU Registered Nurses were recruited from across two adult Intensive Care Units (ICU) in Southwestern Ontario over six weeks between April and May of 2021. Three themes have emerged from the data and provide both a pre-pandemic and intra-pandemic view from the perspective of participants: (1) Family presence during rounds versus family updates after rounds; (2) Nursing the patient versus nursing the family; and (3) Then and now – pre-pandemic versus intra-pandemic implications. Recommendations for future implications and additional research are explored, including nursing education, practice, and policy development, as well as leveraging the use of technology, such as iPads and conferencing software, to conduct virtual rounds and create a hybrid model of family-centered care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".