Nurses' experience of family-centered rounds in the intensive care unit

Abstract

<p>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.</p> <p>This qualitative study uses a phenomenological approach guided by the philosophical underpinnings of Maurice Merleau-Ponty to describe frontline ICU nurses&rsquo; 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 &ndash; 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.</p>