Using a Clinical Indicators Checklist to Determine Family Meeting Needs

Abstract

Problem & Purpose: Patients admitted to the surgical intensive care unit (SICU) are critically ill and may be unable to participate in their care, passing the burden of decision-making onto their family. Family members often express dissatisfaction with the healthcare team communication, making it difficult for them to make informed decisions about their loved ones. Studies have shown implementing family meetings within 72 hours of ICU admission improves communication between family members and the healthcare team. This quality improvement project aimed to improve family satisfaction with the healthcare team communication by implementing interdisciplinary family meetings within 72 hours of SICU admission for families of patients who meet specific clinical indicators. Methods: A checklist was developed based on the literature and input from the nurse educator, nurse manager, and medical director, to recognize specific clinical indicators with which a patient presents that likely require proactive communication from the healthcare team. The presence of at least one indicator prompted a response in which the dayshift nurse notified the unit social worker and SICU provider to initiate a family meeting within 72 hours of ICU admission. To determine a family member’s level of satisfaction with the healthcare team communication, the SICU family liaison distributed the Family Satisfaction With Intensive Care Unit 24R (FS-ICU 24R) questionnaire after the patient was discharged from the SICU. Results: There was a statistically significant increase in the completion of the clinical indicators checklists, X2 (1, n=964) = 75.96, p < 0.001. The number of family meetings did not increase significantly from pre- to post-implementation. The Fisher exact test statistic value was .52. The result was not significant at p < .05. Fifteen families were updated at the bedside (46.9%). Questionnaires returned resulted in satisfaction scores of greater than 75%. Conclusion: Using the clinical indicators checklist may have increased staff awareness for family meeting needs. However, conclusions could not be drawn from the relationship between family satisfaction and attendance at formal family meetings. Other methods of communication such as updates at the bedside and daily rounds may provide sufficient communication for families of patients who meet minimal clinical indicators.