| Objective1.Based on the concept of patient-family-centered care(PFCC),construct the visiting plan of ICU.2.To study the practical application effect of the patient-family centered visiting scheme in the cardiac surgery intensive care unit.Methods1.Delphi expert letter consultation means was applied to establish patient-family centered visitation scheme.On the basis of literature review and semi-structured interview,a research team was set up to preliminarily formulate ICU visitation program with patient-family as the center of nursing concept as the theoretical framework.Delphi expert letter consultation method was adopted to evaluate and revise the program,and finally form patient-family as the center of visitation program.2.To study the application of patient-family centered visiting scheme.Adopt convenient sampling method,100 patients in the cardiovascular surgical care unit of a certain Grade A hospital in Shan Dong province were selected as the research object,and patients be hospitalized from 2021.4 to 2021.6 as the control group,adopting the restrictive family visit mode.Patients be hospitalized from August to October 2021 were taken as the intervention group,and the patient-family-centered visiting scheme was implemented.The results of delirium,adverse events and the satisfaction of patients’ families were compared between the two groups.Results1.A specific patient-family-centered visiting plan suitable for ICU is constructed.The positive factor of twice Delphi specialist consultation were 94.4% and 100.0%,respectively.The coefficient of expert authority is 0.89 and 0.92 separately.The Kendall harmony coefficient in each time of inquiry was 0.216(P < 0.01)and 0.141(P < 0.01),separately.An ICU patient-family centered visiting plan including 4 core principles,11 implementation projects and 59 specific contents was finally established.2.The patient-family-centered visiting scheme in ICU constructed in this study can be effectively applied to clinical practice.(1)The probability of delirium in the intervention group was 6%,which was lower than that in the restriction group(22%)(P = 0.022)(2)The probability of nosocomial infection was 2% in the intervention group and 4% in the control group(P > 0.05),and there was no statistical difference.(3)The probability of unplanned extubation in the intervention group was lower than that in the control group(P = 0.028).The probability of lower extremity venous thrombosis in the intervention group was lower than that in the control group(P = 0.026).There was no statistical difference in the probability of pressure ulcers between the two groups(P > 0.05).(4)The scores of assurance,information,support,comfort and acceptance dimensions of family satisfaction in the intervention group were 28.54±1.28、29.42±0.95、25.22±1.43、16.46±0.79、12.30±0.99,separately,which were higher than those of 20.36±2.00、21.78±1.82、21.56±2.09、13.38±1.72、9.16±1.60 in the control group,and the difference was statistically significant(P < 0.05).Conclusions1.Taking the patient-family centered nursing concept as the basic framework,combined with China’s national conditions,the visiting plan of ICU was made by literature review,semi-structured interviews,Delphi specialist consultation and other ways,which is highly scientific and operable,and can provide some theoretical basis for the innovation of visiting system in ICU of China.2.A patient-family-centered visit plan can effectively reduce the incidence of delirium,unplanned extubation,and low limb venous thrombosis of patients,improve the satisfaction of family members,and does not increase the incidence of nosocomial infection. |
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