(CCCNP004) OBSERVATION OF FAMILY ENGAGEMENT PRACTICE IN A CARDIOVASCULAR INTENSIVE CARE UNIT

Background: Engaging families in care delivery is recommended by cardiovascular and critical care professional societies. However, actual family engagement practice in critical care has yet to be described. Understanding how family members engage in care is necessary in order to develop strategies to increase care engagement. Thus, the purpose of this study is to describe the current engagement practices in a cardiovascular intensive care unit (CICU).

METHODS AND RESULTS: Family members visiting patients hospitalized in the Jewish General Hospital’s CICU were monitored between September and December 2022. During each observation period, research personnel circulated through the CICU and observed the presence of family members as well as the type and amount of care engagement. The following data was collected: time of day, family presence, number of family members present per patient, observation time per patient, and type of family engagement observed. The type of family engagement observed was categorized as active family presence, communication, direct contribution to care, decision-making, or family needs.

There were 105 patients with 152 observation periods (AM, n=47; PM, n=50; evening, n=55). Seventy-five patients had one observation period, and 30 had multiple observation periods. The mean (±SD) observation time per period per patient was 161.0±47.7 minutes. Most patients (n=61; 58%) had family members visit. The mean number of family members present per period per patient was 1.3±0.6. Family members were present, on average, for 68% of the observation period. The most common types of family engagement domains were communication (n=61; 100%; mean time=74.5±39.1 minutes), active family presence (n=36; 59%; mean time=24.7±14.1 minutes), and direct contribution to care (n=35; 57%; mean time=27.8±16.1 minutes). The most common communication activity was communication with the patient (n=61; 100%; mean time=70.8±39.6 minutes). The most common active family presence activity was presence for physician rounds (n=20; 56%; mean time=23.3±10.6 minutes). The most common direct contribution to care activity was assisting with feeding behaviors (n=23; 66%; mean time=25.8±15.1 minutes).

Conclusion: This is the first study to report direct observations of family engagement practice in a critical care setting. The data generated will inform efforts to design interventions to increase family engagement in acute cardiovascular care. Further studies are required to evaluate optimal family engagement practices to maximize positive patient- and family-centred outcomes.