Improving family

communication and
participation in the ICU
By Omar Rios and Andres Rodriguez
 Good communication with patients who are critically ill and on artificial life
support is likely to be challenging at best and probably nonexistent at worst.
In many of these situations, providers turn to family members as surrogate
decision makers for their critically ill loved one
-Maria Yolanda Fox MS, BSN, APRN-CNS, ACHPN, CCRN
At the Intensive Care Unit in UMC of El Paso, family members often relate the
lack of communication from the interdisciplinary team and high patient acuity as
direct factors influencing stress and dissatisfaction regarding the care of their
loved one
Goals of the Project

Iidentify the needs of family members

Promote proactive communication and participation via early family
conferences
To improve staff-family relationship
Continue making changes to provide better costumer satisfaction
Identifying family needs

In order to establish family needs the FS-ICU (24) survey was used

Inclusion Criteria:
1. Patient needs to be admitted for at least 48 hrs
2. Survey needs to be answered by the next of kin
3. Only two surveys per patient are allowed
Improving family communication and
participation
Providing proactive family conferences using clinical triggers

Current Clinical Triggers

Severe Neurologic Injury
Multiple Vasoactive Drugs (more tan 2)
Continuous renal replacement therapy if not previously in hemodialysis
Multiple blood products (6 or more in 24 hours)
Severe sepsis or septic shock
Traumatic injuries that would affect the predicted mortality or quality of
life
Benefits of improved Staff-family
relationship
Higher levels of satisfaction from staff and family members
Improved integration and participation from family members in the
interdisciplinary team
Early planning of long term patient management and code status
Decreased levels of stress from staff and family members
Considerable reduction in time spent in conflict resolution with family
members
Holistic patient-centered care
Continuity of Changes

The results of the family satisfaction survey will be reported to management

to make necessary adjustments to improved family satisfaction
The ICU does not report HCAPS scores which are a direct source of hospital
revenue, however overall hospital stay will influence final score
This is the first standardized survey used in this hospital to measure family
member satisfaction in the ICU at this facility