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Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients

BACKGROUND: Patients leaving the intensive care unit (ICU) often experience gaps in care due to deficiencies in discharge communication, leaving them vulnerable to increased stress, adverse events, readmission to ICU, and death. To facilitate discharge communication, written summaries have been impl...

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Autores principales: Shahid, Anmol, Sept, Bonnie, Kupsch, Shelly, Brundin-Mather, Rebecca, Piskulic, Danijela, Soo, Andrea, Grant, Christopher, Leigh, Jeanna Parsons, Fiest, Kirsten M, Stelfox, Henry T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9305680/
https://www.ncbi.nlm.nih.gov/pubmed/36051938
http://dx.doi.org/10.5492/wjccm.v11.i4.255
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author Shahid, Anmol
Sept, Bonnie
Kupsch, Shelly
Brundin-Mather, Rebecca
Piskulic, Danijela
Soo, Andrea
Grant, Christopher
Leigh, Jeanna Parsons
Fiest, Kirsten M
Stelfox, Henry T
author_facet Shahid, Anmol
Sept, Bonnie
Kupsch, Shelly
Brundin-Mather, Rebecca
Piskulic, Danijela
Soo, Andrea
Grant, Christopher
Leigh, Jeanna Parsons
Fiest, Kirsten M
Stelfox, Henry T
author_sort Shahid, Anmol
collection PubMed
description BACKGROUND: Patients leaving the intensive care unit (ICU) often experience gaps in care due to deficiencies in discharge communication, leaving them vulnerable to increased stress, adverse events, readmission to ICU, and death. To facilitate discharge communication, written summaries have been implemented to provide patients and their families with information on medications, activity and diet restrictions, follow-up appointments, symptoms to expect, and who to call if there are questions. While written discharge summaries for patients and their families are utilized frequently in surgical, rehabilitation, and pediatric settings, few have been utilized in ICU settings. AIM: To develop an ICU specific patient-oriented discharge summary tool (PODS-ICU), and pilot test the tool to determine acceptability and feasibility. METHODS: Patient-partners (i.e., individuals with lived experience as an ICU patient or family member of an ICU patient), ICU clinicians (i.e., physicians, nurses), and researchers met to discuss ICU patients’ specific informational needs and design the PODS-ICU through several cycles of discussion and iterative revisions. Research team nurses piloted the PODS-ICU with patient and family participants in two ICUs in Calgary, Canada. Follow-up surveys on the PODS-ICU and its impact on discharge were administered to patients, family participants, and ICU nurses. RESULTS: Most participants felt that their discharge from the ICU was good or better (n = 13; 87.0%), and some (n = 9; 60.0%) participants reported a good understanding of why the patient was in ICU. Most participants (n = 12; 80.0%) reported that they understood ICU events and impacts on the patient’s health. While many patients and family participants indicated the PODS-ICU was informative and useful, ICU nurses reported that the PODS-ICU was “not reasonable” in their daily clinical workflow due to “time constraint”. CONCLUSION: The PODS-ICU tool provides patients and their families with essential information as they discharge from the ICU. This tool has the potential to engage and empower patients and their families in ensuring continuity of care beyond ICU discharge. However, the PODS-ICU requires pairing with earlier discharge practices and integration with electronic clinical information systems to fit better into the clinical workflow for ICU nurses. Further refinement and testing of the PODS-ICU tool in diverse critical care settings is needed to better assess its feasibility and its effects on patient health outcomes.
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spelling pubmed-93056802022-08-31 Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients Shahid, Anmol Sept, Bonnie Kupsch, Shelly Brundin-Mather, Rebecca Piskulic, Danijela Soo, Andrea Grant, Christopher Leigh, Jeanna Parsons Fiest, Kirsten M Stelfox, Henry T World J Crit Care Med Observational Study BACKGROUND: Patients leaving the intensive care unit (ICU) often experience gaps in care due to deficiencies in discharge communication, leaving them vulnerable to increased stress, adverse events, readmission to ICU, and death. To facilitate discharge communication, written summaries have been implemented to provide patients and their families with information on medications, activity and diet restrictions, follow-up appointments, symptoms to expect, and who to call if there are questions. While written discharge summaries for patients and their families are utilized frequently in surgical, rehabilitation, and pediatric settings, few have been utilized in ICU settings. AIM: To develop an ICU specific patient-oriented discharge summary tool (PODS-ICU), and pilot test the tool to determine acceptability and feasibility. METHODS: Patient-partners (i.e., individuals with lived experience as an ICU patient or family member of an ICU patient), ICU clinicians (i.e., physicians, nurses), and researchers met to discuss ICU patients’ specific informational needs and design the PODS-ICU through several cycles of discussion and iterative revisions. Research team nurses piloted the PODS-ICU with patient and family participants in two ICUs in Calgary, Canada. Follow-up surveys on the PODS-ICU and its impact on discharge were administered to patients, family participants, and ICU nurses. RESULTS: Most participants felt that their discharge from the ICU was good or better (n = 13; 87.0%), and some (n = 9; 60.0%) participants reported a good understanding of why the patient was in ICU. Most participants (n = 12; 80.0%) reported that they understood ICU events and impacts on the patient’s health. While many patients and family participants indicated the PODS-ICU was informative and useful, ICU nurses reported that the PODS-ICU was “not reasonable” in their daily clinical workflow due to “time constraint”. CONCLUSION: The PODS-ICU tool provides patients and their families with essential information as they discharge from the ICU. This tool has the potential to engage and empower patients and their families in ensuring continuity of care beyond ICU discharge. However, the PODS-ICU requires pairing with earlier discharge practices and integration with electronic clinical information systems to fit better into the clinical workflow for ICU nurses. Further refinement and testing of the PODS-ICU tool in diverse critical care settings is needed to better assess its feasibility and its effects on patient health outcomes. Baishideng Publishing Group Inc 2022-07-09 /pmc/articles/PMC9305680/ /pubmed/36051938 http://dx.doi.org/10.5492/wjccm.v11.i4.255 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Observational Study
Shahid, Anmol
Sept, Bonnie
Kupsch, Shelly
Brundin-Mather, Rebecca
Piskulic, Danijela
Soo, Andrea
Grant, Christopher
Leigh, Jeanna Parsons
Fiest, Kirsten M
Stelfox, Henry T
Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
title Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
title_full Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
title_fullStr Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
title_full_unstemmed Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
title_short Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients
title_sort development and pilot implementation of a patient-oriented discharge summary for critically ill patients
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9305680/
https://www.ncbi.nlm.nih.gov/pubmed/36051938
http://dx.doi.org/10.5492/wjccm.v11.i4.255
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