UNMC study to assess engagement of family members in intensive care unit

by Vicky Cerino
June 27, 2018

Image with caption: Breanna Hetland, Ph.D.

Breanna Hetland, Ph.D.

Caregiver participation in patient care leads to better, safer experiences for patients and caregivers. Critical care guidelines call for family caregivers to be active partners in bedside care in the intensive care unit (ICU). But there are few evidence-based strategies to engage family caregivers in specific ways.

A two-year, $50,000 pilot study funded by the American Association of Critical Care Nurses, hopes to change that.

Breanna Hetland, Ph.D., principal investigator of the grant, will test the feasibility and acceptability of a new web application to improve the experience of mechanically ventilated patients and their family caregivers in the adult ICU.

The web app will be installed on tablets provided at Nebraska Medicine. It will offer family caregivers an interactive orientation to the ICU, as well as teach them how to assess, record, and treat two common patient symptoms, thirst and anxiety.

Ventilators are most often used if a disease or condition impairs lung function, but being on a ventilator is uncomfortable. 

"Overuse of sedative and analgesic medications can cause patients to have issues with memory, cognition, emotional stability, and medication withdrawal," Dr. Hetland said. "We strive to reduce our use of these medications, but that’s really hard when you’re a nurse taking care of a patient who’s uncomfortable or agitated. Unfortunately, we don’t have many other options to offer."

She said caregivers can learn simple, appropriate techniques to alleviate patients’ symptoms. Their involvement also may help lessen some of the demand on busy ICU nurses.

"Family caregivers are often better than health care providers at accurately assessing patient symptoms, but we haven’t yet studied whether they can be leveraged to lessen the symptom burden and pharmacologic needs of ventilated patients," Dr. Hetland said.

Researchers will enroll 60 family caregivers -- one group will receive routine ICU care and support. The other group will receive a tablet with the web app and be asked to assess, record, and treat symptoms every four hours when visiting the patient.

"The project will help us further define the scope, extent, and nature of patient and family engagement in the ICU," Dr. Hetland said. "If proven feasible, our intervention holds the potential to shift current ICU nursing practices by integrating family caregivers as dynamic partners in care."

The research team plans to launch the study in the Fred & Pamela Buffett Cancer Center Werner ICU and recruit study participants in December.

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