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IntensiveCARE

A system can be known by how well it treats its most vulnerable.

Intensive Care is a complex achievement of modern science and medicine. However, patients and families are often forgotten in the single-pointed focus on the clinical care.

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Brining Care back into InstensiveCARE

Flexible Visitation

Flexible visitation has not been shown to increase rates of infections in ICUs. Evidence does suggest that for patients, flexible visitation decreases anxiety, confusion, and agitation, decreases length of ICU stay, makes the patient feel more secure, increases patient satisfaction, and increases quality and safety. For patients’ family members, evidence suggests that unrestricted visitation increases satisfaction, decreases anxiety, promotes better communication, contributes to better understanding of the patient, allows more opportunities for patient/family teaching as the family becomes more involved in care.

A chair at the bedside

How long do family members stand when a loved one is in the hospital? Often for days on end.

There are countless tasks that family members have to do for loved ones, making meals, bringing things to and fro from the hospital, taking difficult decisions with incomplete information and knowledge, managing their own and each others emotions. Many do not get any sleep and do not eat well.

Visitors may themselves have disabilities that make it hard or impossible for them to stand

The least we can do is give visitors a place to sit.

Supportive environment

ICUs with its isolation, constant noise, light and other disturbances can exacerbate poor outcomes for patients. Delirium in critically ill patients either during the ICU stay or prolonged delirium post-discharge can be harmful and stressful for patients and families. Evidence based practices exist to reduce the propensity for delirium in critically ill patients.

Humane systems lead to better outcomes.

The ICU is a technological, medical marvel. However, it is purely focused on the mechanics of keeping the human body functional. This leads to disregard for the human, emotional and psychological trauma that ICU patients and families undergo. We must try to make ICUs more humane and identify solutions for the challenges in enabling flexible visitation and better communication for patients can caregivers.

In neonatal ICUs it is now routine practice to provide reclining chairs for mothers and family members to practice Kangaroo Mother Care (KMC). KMC (human touch) has proven life saving for newborns. Developmentally Supportive Care and Family Centered Care models which have emerged for neonatal ICUs must also be extended to pediatric and adult ICUs for better outcomes and humane care.