The dissertation was written and presented by Mary L. Jahrsdoerfer in 2014 at University of Massachusetts Amherst. The primary focus of the study was to bridge the gap of complexities of tele-ICU which in many instances required nurses to have family knowledge experiences to meet their needs. This is achieved through explanatory inquiry of family needs.
The research aimed at bridging the gap in nursing knowledge related to family needs in the tele-ICU. Both the family and the patient have been experiencing difficulties at ICU thus affecting their familys patterns of functioning. The problem arises from the complex structure of tele-ICU which affected the family needs and perceptions. The family cannot participate in advising on medical procedures because it is mainly done via video screen or audio. The investigators have extensively investigated this problem and have put it to their knowledge which is demonstrated by nurses placing family needs as part of their overall care plan. This study is likely to solve the rising cases of family dysfunction brought about by the effect of tele-ICU.
The purpose of the research is to explore, identify and describe the needs and perceptions of the family members of a patient admitted At ICU and to determine if their needs are different from recommended by the Critical Care Family Needs Inventory (CCFNI).
Review of the Literature
The literature addressed three primary subjects which are the effects of needs and experiences on the family members of patients brought about by traditional ICU experience, structure, design, and environment of conventional ICU, and structure, design, and atmosphere of the tele-ICU. The study performed initial literature search through electronic databases such as CINAHL and Google Scholar to identify publications related to the study problem. Additionally, the study covered many aspects of the family such as family-focused care, family in the context of both traditional and tele-ICU, measuring their needs in ICU, and last specific details of the tele-ICU and traditional ICU (Aiken et al., 2008).
The references used by the study was current because they obtained from popular nursing databases such as CINAHL, Medline Plus, and Google Scholar. Moreover, they used sources from the University of Massachusetts which are relevant to their study.
The research used the Family Stress Model theoretical framework from McCubbin and Pattersin (1983) as a guiding principle. The model was strengthened by the use of tele-ICU pilot study and CCFNI tool. Both the two instruments are well defined and are related to the research because they it links the familys ability with resources available and experience with stressor in their life. The study used theories of other studies such as paradigm perspective, theory development, and different external approaches to analyze the matter.
The theoretical framework of the Family Stress Model is stated and used in the analyzing the family needs and perspectives. The framework greatly helped to identify existing peer-reviewed studies about the family needs in the traditional ICU and how tele-ICU pilot study and CCFNI can be used in tele-ICU setting (Berti, Ferdinand & Moons, 2007).
The study depended on research question which was guided by various objectives. The main research studied the needs and perceptions of the family members of patients who are at a tele-ICU about those when in the traditional ICU. This research question is guided by some of the study goals which include the determining if family needs in both tele-ICU and traditional ICU are similar, establishing if the CCFNI is required to be refined, and identifying critical themes for the new care model.
The study assumes that the needs and perception of the family had not been gathered for at the tele-ICU where their patient is admitted. This called for further research of the overall care plan to develop it to include family as the extension of the patient. Furthermore, the study assumed there was the need for a pro-active approach that aims at ensuring needs of the families are met.
The study used qualitative study since it involved semi-structured recorded interview method to assess the family needs, experiences and perceptions. The research also used explanatory inquiry to expound CCFNI findings in the traditional ICU. The study used deductive reasoning method because they first addressed the problem from the more general perspective and slowly addressing specific issues concerning the effects of tele-ICU. The research used a sample size of approximately 14 persons from at least ten families. They used random sampling as the participants were selected on a voluntary basis. The study setting was from 4 tele-ICUs at different academic campuses within the UMass Worcester Memorial Centre System.
The study used a probability sample because each participant was chosen randomly and given equal chances of being selected. Inter-Observer Reliability type of reliability and content validity when analyzing the data from the interviews. Moreover, the study was ethical because it respected the rights of patients and their families as well as their privacy and confidentiality.
The study used an exploratory, descriptive method which is a form of qualitative research. This design leaves a door for inessential information, interpretation and questionable value. Moreover, the process takes into account validity, reliability and replicability of the research to make the findings accurate (Jahrsdoerfer, 2014). However, the design attracted biases that may have affected the outcomes.
The research arrived at several findings, and the results were presented using several themes. The study found that the family lacked the opportunity to receive valuable information from the staff. They also found positive factors concerning family presence at the patient bedside. Additionally, the study found the need for both assurance and comfort within the ICU to enhance the patients care. Lastly, the study found the need of support and encouragement for the patients family members.
Summary/Conclusions, Implications, and Recommendations
The study succeeded in analyzing the impacts of tele-ICU on the patients as well as their families. It managed to present accurate findings concerning the tele-ICU and its relationship with family needs of assurance, information, support, proximity and knowledge id tele-ICU function. However, the study was only limited to one health system rather than be broadened to multiple health systems. The interviews also encouraged biased because of being conducted while patients are in ICU thus affecting the mental state of the family.
The findings can be generalized because it touched on several aspects such as comfort, the supply of information and knowledge of medical equipment which are common in many health institutions. The findings will be significant because it breaks the communication between the patients family and the tele-ICU staff.
Aiken, L., Clarke, S., Sloane, D., Lake, E., & Cheney, T. (2008). Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes. Journal of Nursing Administration, 38(5), 223-229
Berti, D., Ferdinand, P., & Moons, P. (2007). Beliefs and attitudes of intensive care nurses toward visits and open visiting policy. Intensive Care Medicine, 33(6), 1060-1065.
Jahrsdoerfer, M. L. (2014). Needs Of Patients Families in the Hospital Tele-Intensive Care Unit. ScholarWorks@UMass Amherst, 1-204
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