Nurses' Role in Transitional Care During Intensive Care Unit Family Meetings for Patients With Prolonged Mechanical Ventilation

护士在重症监护病房过渡期护理中的作用:长期机械通气患者的家属会议

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Abstract

AIM: To describe nurses' roles in transitional care planning during intensive care unit (ICU) family meetings for patients with prolonged mechanical ventilation (PMV). DESIGN: A qualitative descriptive study. METHODS: Using secondary data from a trial of a decision aid about PMV, transcripts from 19 unstructured ICU family meetings were purposively sampled and analysed using directed content analysis. FINDINGS: Among 76 recorded ICU family meetings where nurses engaged and spoke at length beyond introduction, nurses spoke at length in 19 (25%) of them. These 19 family meetings were analysed in depth. Three themes were identified describing the roles nurses served: (1) Transitional care liaisons (e.g., introducing next levels of care, identifying/engaging family members, providing patient/family education, managing medications, planning for discharge, assessing patient/family needs, coordinating care, setting goals, providing care continuity, offering provider guidance and referring to resources); (2) information and communication facilitators (e.g., moderating family meetings, facilitating family understanding and serving as communication intermediaries) and (3) family support providers (e.g., providing emotional support, describing expectations and advocating for patients/families). CONCLUSION: Although nurses play a central role in patient care, they engage in only a minority of ICU family meetings addressing transitional care planning. Increased nursing involvement in these discussions may enhance care coordination and better support families navigating complex care transitions. IMPLICATIONS FOR CLINICAL PRACTICE: Findings suggest that more consistent engagement of nurses in ICU family meetings has the potential to support transitional care planning and family-centred care for patients with PMV and their families. IMPACT: This work adds to a growing body of knowledge about nurses' role in ICU transitional care planning. These findings provide valuable guidance for future research and development of transitional care standards to guide nurses in ICU transitional care planning. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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