NURSES AS INTERMEDIARIES: HOW CRITICAL CARE NURSES PERCEIVE THEIR ROLE IN FAMILY MEETINGS
NURSES AS INTERMEDIARIES: HOW CRITICAL CARE NURSES PERCEIVE THEIR ROLE IN FAMILY MEETINGS
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DOI：
10.4037/ajcc2016653
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发表时间：
2016-01-01
影响因子：
2.7
通讯作者：
Lorenz, Karl A.
中科院分区：
文献类型：
--
作者：
Ahluwalia, Sangeeta C.;Schreibeis-Baum, Hannah;Lorenz, Karl A.
背景护士参与重症监护室的家庭会议是支持护理团队内部以及与患者和患者家属进行一致沟通和共享理解的核心。证据表明存在的主要障碍，有效参与和贡献的护士在家庭meetings.Objectives的性质和程度的特点，护士参与家庭会议在重症监护病房，包括确定障碍，护士的参与和机会involvement.Methods会议与焦点小组的护士在退伍军人事务部医疗重症监护病房记录，转录，结果30名重症护理护士参加了6个焦点小组的调查。三大主题描述护士参与家庭会议确定：护士可以发挥多种作用，在支持家庭会议的行为，护士面临的关键障碍，充分实现这些角色，护士最终作为中间人在家庭会议。次主题涉及到被定位为病人的拥护者，但感觉低估和不足，以贡献重要的信息在家庭会议上，往往会导致混合信息的护理偏好，预后，或护理的目标，护士不觉得能够解决在meeting.Conclusion护士定位在家庭会议中发挥重要作用，但他们的充分参与仍然没有实现。沟通培训和更加重视护士的赋权和促进护士与医生的关系，在家庭会议的背景下，最有可能增加护士在会议中的适当参与。
Background Nurses' involvement in family meetings in the intensive care unit is central to supporting consistent communication and shared understanding within the care team and with patients and patients' family members. Evidence suggests the existence of major barriers to the effective participation and contribution of nurses during family meetings.Objectives To characterize the nature and extent of nurses' involvement in family meetings in the intensive care unit, including identifying barriers to nurses' participation and opportunities for involvement.Methods Meetings with focus groups of nurses at a Veterans Affairs medical intensive care unit were recorded, transcribed, and qualitatively analyzed by using the constant comparative method.Results Thirty critical care nurses participated in 6 focus groups. Three major themes describing nurses' involvement in family meetings were identified: nurses can play multiple roles in supporting conduct in family meetings, nurses face critical barriers to fully realizing these roles, and nurses end up as intermediaries in family meetings. Subthemes pertained to being well positioned to act as the patient's advocate, yet feeling undervalued and underempowered to contribute important information in family meetings, often resulting in mixed messages about care preferences, prognosis, or goals of care that nurses did not feel able to address during the meeting.Conclusion Nurses are positioned to play essential roles in family meetings, but their full involvement remains unrealized. Communication training and greater attention to nurses' empowerment and to facilitating the nurse-physician relationship in the context of family meetings most likely would increase appropriate involvement of nurses in the meetings.