Communication in Intensive Care

13  Download (0)

Full text


Communication in Intensive Care

Group “Communication”

D Biarent, L Huygens, L Bossaert, De Jongh, Y Somers, M Laurent, M Slingemeyer


Goals of communication

Quality of communication between HCP and family could play a role on recovery of patients Tilly, AJM 2000

Family want to be informed and to participate to medical decision

Molter DCCN, 1994;13:2-3

Jacob Am J Crit Care, 1998;7:30-36

Family are waiting honest information Harvey Crit Care Med, 1993;4:484-549

No rational behind exclusion of the family during care of the patient

Robinson Lancet, 1998;352:614-17



Ideally : query directed to patient and/or family Questionnaire directed to ICU directors

 Only on voluntary basis

 Profile of all Belgian units

 Indirect tools to measure level of information and communication

 Sensitisation



 Evaluation of modalities of reception of a patient and his family in ICU

Architecture for reception/admission

Schedules and organisation for visiting ICU patient



 Communication (indirect evaluation)

Identification of HCP

Modalities of information of relatives

Delivery of bad news/prognosis

Modalities of information of GP

 Team

Psychological support


Transmission of information


DNR order



 Number of ICU 39 / 134 (28.3 %)

 Number of beds 637

 Visits limited to less than 2 h/day

 Children admitted from 10 y of age

 Family is accompanied by HCP during admission/resuscitation

 Relative not allowed to witness resuscitation / procedure


 Interviews with family are frequent but not structured

 Possibility for family to stay during night are scarce

 Bad news delivery


Structured interview with relatives: who speaks

Intensivists 82%

Dr in charge 63%

Specialists 50%

Psychologist 13%

Resident 39%

Nurse 63%

Cultural repres 26%

GP 26%

Also present


Structured interview with

relatives: teaching & discussion

Discussion/communication after bad news delivery

Unformal: 63%

Organised during staff meeting: 66%

Psychiatrist liaison meeting: 8%

Written report: 55%


Team psychologic help / support

Individual systematic: 5%

Individual on request: 29%

Group systematic: 11%

Group on request: 24%


Patient’s files

 Fully computerised files : 30%

 Partially computerised : 41%

 Limited access for some HCP categories : 91%

 Nursing file access for relatives : 54%

 Patient file access for relatives : 59%


Death of patients

 Family members are informed that death of their relative is near in 98%

 Relatives are present during the death event in 84%

 Relatives may stay longer in privacy with the deceased in 24%



Obvious concern from majority of ICU to

communicate with relatives (dedicated HCP, frequent information during resuscitation, HCP identification, oldest children accepted)

Presence during procedure and resuscitation, length of visit, possibility to stay with the patient, visit of

youngest children, bad news delivery modalities and teaching are subject to possible improvement

Architectural limitation impairs confidentiality

Lack of psychological support




Related subjects :