Abstract:
AIMS AND OBJECTIVES:To explore patients', families' and health professionals' experiences of a long-stay patient in an intensive care unit. BACKGROUND:The fast-paced technologically driven intensive care unit environment, designed for a short patient stay, supports the provision of complex physiologically focused care for those with life-threatening illnesses. Long-stay patients with pronounced fundamental care needs fall outside predicted patient pathways, and nurses can find caring for these patients challenging. DESIGN AND METHODS:A longitudinal, qualitative, multicase study of six cases from four New Zealand units. Case participants were patients, family members, nurses and other health professionals. Data collection methods included observation, conversations, interviews and document review. Data were analysed using thematic analysis, vignette development and trajectory mapping. RESULTS:Challenges and successes of providing fundamental care for long-stay ICU patients are attributed to two interlinked factors. First, the biomedical model influences ICU nursing practices, resulting in prioritising tasks and technology for patient survival while simultaneously devaluing relational and comfort work. Fundamental psychosocial needs such as family presence, comfort, relationships and communication may be unmet. Second, the unit environment and culture have a significant impact on long-stay patients' ICU experiences and form physical and psychological barriers to families being present and involved. Some nurses negotiated these challenges to provide fundamental, patient- and family-centred care by adopting an approach of knowing the patient and these nurses reported satisfaction when seeing patients' positive responses. CONCLUSION:The care environment and culture provide challenges to the provision of patient- and family-centred care for long-stay patients; however, when nurses prioritise knowing their patient these challenges can be overcome and patient and family distress reduced with the potential to improve patient outcomes. RELEVANCE TO CLINICAL PRACTICE:Recognition that patients have fundamental care needs irrespective of the setting where they receive care. Intensive care environments and cultures create challenges for nurses when there is such a heavy burden of physiological needs to be met and technological tasks to be undertaken, with a focus on acuity; however, improving provision fundamental care can result in positive patient outcomes.
journal_name
J Clin Nursjournal_title
Journal of clinical nursingauthors
Minton C,Batten L,Huntington Adoi
10.1111/jocn.14184subject
Has Abstractpub_date
2018-06-01 00:00:00pages
2300-2310issue
11-12eissn
0962-1067issn
1365-2702journal_volume
27pub_type
杂志文章abstract:AIM:To describe operating theatre nurses' experience of preconditions for safe intraoperative nursing care and teamwork. BACKGROUND:Surgical interventions are often needed for patients' well-being and survival from health problems. Adequate information to professionals responsible within the surgical organisation is o...
journal_title:Journal of clinical nursing
pub_type: 杂志文章,多中心研究
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更新日期:2019-07-01 00:00:00
abstract:AIMS AND OBJECTIVES:To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to pati...
journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/jocn.14728
更新日期:2019-04-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1046/j.1365-2702.2003.00771.x
更新日期:2003-09-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1046/j.1365-2702.2000.00390.x
更新日期:2000-05-01 00:00:00
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journal_title:Journal of clinical nursing
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doi:10.1111/jocn.14364
更新日期:2018-05-01 00:00:00
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journal_title:Journal of clinical nursing
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journal_title:Journal of clinical nursing
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
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更新日期:2015-07-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章,评审
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更新日期:1998-07-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
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更新日期:2007-11-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
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更新日期:2013-07-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章,多中心研究
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2011.03790.x
更新日期:2012-01-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2702.2012.04114.x
更新日期:2012-07-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2011.03813.x
更新日期:2011-10-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2010.03405.x
更新日期:2011-03-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1046/j.1365-2702.2001.00484.x
更新日期:2001-05-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章,评审
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更新日期:2017-10-01 00:00:00
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journal_title:Journal of clinical nursing
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journal_title:Journal of clinical nursing
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2011.03700.x
更新日期:2012-02-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2008.02599.x
更新日期:2009-03-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2702.1994.tb00409.x
更新日期:1994-11-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2011.03840.x
更新日期:2012-07-01 00:00:00
abstract:AIMS AND OBJECTIVES:The aim of this study was to explore the experiences and concerns of individuals with type 2 diabetes mellitus, in a predominantly low socio-economic setting. BACKGROUND:Currently, approximately 1 million Australians have diabetes and rates have more than doubled since 1989. Type 2 diabetes mellitu...
journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/jocn.12724
更新日期:2015-04-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2007.02082.x
更新日期:2007-11-01 00:00:00
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journal_title:Journal of clinical nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2702.2008.02284.x
更新日期:2008-07-01 00:00:00