Construction Of A Patient-and Family-centered ICU Visitation Program

Research Purpose:1.To understand the current status of research on patient family-centered ICU visitation model in China.2.Define the philosophy,core and principles of patient family-centered care in the ICU and use them as a framework to develop the ICU visitation program.3.To compile evidence related to patient family-centered ICU visitation,and construct a relevant patient family-centered ICU visitation program based on the concept of patient family-centered care in ICU to reduce anxiety and depression in patients and families,reduce the incidence of post-ICU syndrome in patients,and improve patient and family satisfaction.Research Methods:1.Establish the research group,determine the research theme,and design the research plan.2.Evidence-based nursing research methods.(1)Literature quality evaluation: systematic search of domestic and international Chinese and English databases such as Joanna Briggs Institute(Center for Evidence-Based Health Care database),Cochrane Library,Pub Med,and Chinese Biomedical Literature Database(CBM)to obtain systematic evaluation as well as original studies and trace the relevant references for systematic evaluation.The quality evaluation of the literature using the JBI Center for Evidence-Based Health Care(2016)literature quality evaluation criteria was applied for relevant evidence extraction.(2)Relevant guideline analysis: search domestic and international clinical practice guideline networks,such as the National Guideline Collection(NGC),the National Institute for Health and Clinical Excellence(NICE),and the Registered Nurses Association of Ontario(RNAO),Canada,to obtain relevant guidelines and trace the relevant references of the guidelines.The Johns Hopkins-Clinical Practice Guidelines Quality Assessment Method was used to evaluate the quality of guidelines and perform relevant evidence extraction.(3)Summarize the above relevant evidence and grade the evidence entries according to the JBI evidence pregrading system.(4)Form a first draft of the patient family-centered visitation program3.Delphi method(expert consultation method)Using the expert consultation method(Delphi method),18 clinicians and nursing experts in the field of critical care in Zhejiang Province were selected for two rounds of correspondence,and the results were analyzed and the feedback from the experts was summarized to finally establish a localized patient family-centered ICU visitation program.Research Results:1.A total of 32 papers were included in the final study,including 2 clinical practice guidelines,2 clinical practice standards,3 JBI evidence summaries,8 systematic evaluations and reviews,and17 original studies;the preliminary ICU flexible visitation program covers respecting and meeting the reasonable visitation needs of patients and families,promoting cooperation between ICU and families,enhancing information sharing between doctors and patients,guiding families to The five aspects and 45 specific indexes of quality control are included.2.The effective rate of questionnaire return in the two rounds of expert consultation was 88%and 100%,respectively;the authority coefficient of experts was 0.90,and the coefficient of variation of importance,coefficient of variation of operability,and coefficient of coordination of each index in the second round of consultation were 0.00-0.23,0.11-0.25,and 0.266 and 0.178,respectively,with Ρ values <0.01.3.The final patient-and family-centered visitation protocol included 5 dimensions and 42 specific indicator components.Research Conclusion:The "Patient Family-Centered ICU Visitation Program" constructed in this study based on evidence-based nursing and Delphi expert survey method includes four aspects: respecting and meeting the reasonable visiting needs of patients and their families,promoting cooperation between doctors and patients,strengthening information sharing between doctors and patients,and encouraging and guiding family members to participate in patients’ life care,with a rigorous and standardized construction process and scientific and reliable results,which is suitable for the ICU in China.It is suitable for the current clinical situation in China.The protocol provides evidence to support the implementation of family-centered ICU visits in China and provides a theoretical basis for further clinical application and promotion.