TY - JOUR
T1 - A quality improvement project to support post-intensive care unit patients with COVID-19
T2 - structured telephone support
AU - op 't Hoog, Sabine A. J. J.
AU - Eskes, Anne M.
AU - van Oers, Jos A. H.
AU - Boerrigter, José L.
AU - Prins-Smulders, Meike W. J. C.
AU - Oomen, Margo
AU - van der Hoeven, Johannes G.
AU - Vermeulen, Hester
AU - Vloet, Lilian C. M.
N1 - Vol. 19, Iss. 15 August-1 2022. Supplementary materials: The following are available online at: https://www.mdpi.com/article/10.3390/ijerph19159689/s1. Table S1. Qualitative data quotes and categories ordered by PICS-framework.
PY - 2022/8/6
Y1 - 2022/8/6
N2 - Background: More than 50% of intensive care unit (ICU) survivors suffer from long-lasting physical, psychosocial, and cognitive health impairments, also called “post-intensive care syndrome” (PICS). Intensive care admission during the COVID-19 pandemic was especially uncertain and stressful, both for patients and for their family. An additional risk of developing symptoms of PICS was feared in the absence of structural aftercare for the patient and family shortly after discharge from the hospital. The purpose of this quality improvement study was to identify PICS symptoms and to support post-intensive care patients and families in the transition from the hospital to the home. Therefore, we offered post-ICU patients and families structured telephone support (STS). Methods: This was a quality improvement study during the 2019 COVID-19 pandemic. A project team developed and implemented a tool to structure telephone calls to identify and order symptoms according to the PICS framework and to give individual support based on this information. We supported post-ICU patients diagnosed with COVID-19 pneumonia and their family caregivers within four weeks after hospital discharge. The reported findings were both quantitative and qualitative. Results: Forty-six post-ICU patients received structured telephone support and reported symptoms in at least one of the three domains of the PICS framework. More than half of the patients experienced a loss of strength or condition and fatigue. Cognitive and psychological impairments were reported less frequently. Family caregivers reported fewer impairments concerning fatigue and sleeping problems and expressed a need for a continuity of care. Based on the obtained information, the ICU nurse practitioners were able to check if individual care plans were optimal and clear and, if indicated, initiated disciplines to optimize further follow-up. Conclusions: The implementation of the STS tool gave insight in the impairments of post-ICU patients. Surprisingly, family caregivers expressed fewer impairments. Giving support early after hospital discharge in a structured way may contribute to providing guidance in the individual care plans and treatment of the early symptoms of PICS (-F).
AB - Background: More than 50% of intensive care unit (ICU) survivors suffer from long-lasting physical, psychosocial, and cognitive health impairments, also called “post-intensive care syndrome” (PICS). Intensive care admission during the COVID-19 pandemic was especially uncertain and stressful, both for patients and for their family. An additional risk of developing symptoms of PICS was feared in the absence of structural aftercare for the patient and family shortly after discharge from the hospital. The purpose of this quality improvement study was to identify PICS symptoms and to support post-intensive care patients and families in the transition from the hospital to the home. Therefore, we offered post-ICU patients and families structured telephone support (STS). Methods: This was a quality improvement study during the 2019 COVID-19 pandemic. A project team developed and implemented a tool to structure telephone calls to identify and order symptoms according to the PICS framework and to give individual support based on this information. We supported post-ICU patients diagnosed with COVID-19 pneumonia and their family caregivers within four weeks after hospital discharge. The reported findings were both quantitative and qualitative. Results: Forty-six post-ICU patients received structured telephone support and reported symptoms in at least one of the three domains of the PICS framework. More than half of the patients experienced a loss of strength or condition and fatigue. Cognitive and psychological impairments were reported less frequently. Family caregivers reported fewer impairments concerning fatigue and sleeping problems and expressed a need for a continuity of care. Based on the obtained information, the ICU nurse practitioners were able to check if individual care plans were optimal and clear and, if indicated, initiated disciplines to optimize further follow-up. Conclusions: The implementation of the STS tool gave insight in the impairments of post-ICU patients. Surprisingly, family caregivers expressed fewer impairments. Giving support early after hospital discharge in a structured way may contribute to providing guidance in the individual care plans and treatment of the early symptoms of PICS (-F).
KW - COVID-19
KW - evidence-based quality improvements
KW - family-centered care
KW - intensive care unit
KW - nurse-led
UR - http://www.scopus.com/inward/record.url?scp=85136341313&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/ijerph19159689
DO - https://doi.org/10.3390/ijerph19159689
M3 - Article
C2 - 35955045
SN - 1661-7827
VL - 19
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 15
M1 - 9689
ER -