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Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Nursing

Year Degree Awarded

Summer 2014

First Advisor

Linda Lewandowski, PhD, RN

Second Advisor

Cynthia Jacelon, PhD, RN

Third Advisor

Rebecca Ready, PhD

Subject Categories

Critical Care Nursing | Medicine and Health Sciences

Abstract

Purpose: To explore, identify and describe the perceptions of family members of a patient admitted to a telemedicine intensive care unit (tele-ICU); and to determine if these needs differ from those established by the Critical Care Family Needs Inventory (CCFNI) in the traditional ICU setting.

Background: The tele-ICU is a new care modality in which offsite nurses provide consultation to bedside clinical staff at geographically-dispersed ICUs. The last decade demonstrates a growing existence of tele-ICU’s in our healthcare culture. ’Information’, ‘close proximity’, ‘assurance’, ‘support’ and ‘comfort’ have been identified as the top five needs of family members in the traditional ICU setting. Yet, we do not know what the family needs are within the tele-ICU context.

Significance: The complexity of the tele-ICU adds another dimension to patient-family care, requiring nurses to have appropriate knowledge of family member experiences in order to meet these needs. This study was the first of its kind using face-to-face interviews to focus on the unique perceptions and needs of family members in this new care modality; and a follow-up to the published pilot study by this author.

Methods: This was a descriptive study using exploratory inquiry; semi-structured recorded interview method was used with a convenience sample of family-members to assess their experiences, needs, and perceptions while patients received care in a tele-ICU.

Conclusion: This study demonstrated significant gaps in communication about the tele-ICU between staff and patients’ family. This finding is consistent with the pilot study. Although once informed about the tele-ICU existence and purpose by the investigator, perceptions of the tele-ICU model of care were generally favorable. The fact that 11 of the 16 family-participants interviewed (68.75%) indicated that they had not been informed that the patient was receiving care in a tele-ICU, as well as all 16 (100%) of the respondents never having been introduced to the remote staff, suggests the need for more timely, organized, and proactive communication strategies to inform patients’ family members about this novel technology. Improved comprehension of the families’ understanding of the role of the tele-ICU in the care of critically ill patient may support their informational needs.

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