How does a nursing crisis management intervention impact relatives' experiences in two trauma centres? A time-series study

Mia Blaabjerg , Anne Sophie Ågård , Marianne Lisby
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Abstract

Background

Being a relative to a trauma patient may be a dramatic experience. Often, trauma centre nurses do not feel they have the competences needed to meet relatives experiencing a crisis. Therefore, a need exists to enhance their crisis management competencies.

Objective

To investigate relatives' experiences of a nursing crisis management intervention on information, inclusion and support, including the importance of these needs in two Danish trauma centres.

Design

A prospective intervention study based on interrupted time series. The intervention, conducted in 2020–2021, consisted of a crisis management training programme.

Setting(s)

The Trauma Centre of the Aarhus University Hospital and Aalborg University Hospital in Denmark.

Participants

Relatives (18+ years) of critically ill or injured patients (n = 293).

Methods

Data were collected using a 32-item questionnaire. The primary outcome was relatives’ overall experience of the quality of the information, inclusion and support measured on a visual analogue scale (VAS) (0–10). Secondary outcomes were changes in risk ratios and scores between the periods for each of the three main variables. The outcome was measured as weighted and non-weighted scores, taking into account the importance of each variable. Besides use of interrupted time series, predictive and weight-adjusted analyses were performed. Time series comprised a before-period (6 months), an implementation period (3 months) and an after-period (6 months). Due to ceiling effect, the predictive analysis was dichotomized using the median scores for information, inclusion and support.

Results

Overall, no differences were observed between the participants' characteristics in each of the three periods. Comparing the implementation period with the after-period revealed a statistically significant positive difference between the relatives’ assessment of crisis management [p = 0.009]. Additionally, the probability of scoring >8 from before to after the intervention increased statistically significantly [Risk ratio 1.21, 95 % confidence interval 1.16–1.27]. The secondary outcomes showed that the greatest change over time was inclusion of relatives [Risk ratio, 1.25 95 % confidence interval 1.15–1.35]. Information had the greatest effect on relatives’ experience of nurses’ provision of crisis management and was also the needs area that relatives considered most important. However, information was also the needs area that evolved least during the study.

Conclusions

Based on the selected cut-off levels, the intervention appeared to have a positive effect on relatives’ experiences – especially inclusion of relatives. In the weighted analyses, information was considered most important and also had the greatest effect on relatives’ overall experience. Nurses’ crisis management competencies should be prioritized in trauma centres.

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护理危机管理干预如何影响两个创伤中心的亲属体验?时间序列研究
背景作为创伤患者的亲属,可能会有一段戏剧性的经历。通常情况下,创伤中心的护士认为自己不具备应对亲属危机所需的能力。因此,有必要提高他们的危机管理能力。目标调查亲属对护理危机管理干预在信息、包容和支持方面的体验,包括这些需求在丹麦两家创伤中心的重要性。设计基于中断时间序列的前瞻性干预研究。干预于 2020-2021 年进行,包括一项危机管理培训计划。参与者危重病人或伤员的亲属(18 岁以上)(n = 293)。主要结果是亲属对信息质量、包容性和支持的总体体验,采用视觉模拟量表(VAS)(0-10)进行测量。次要结果是三个主要变量在不同时期的风险比和得分的变化。考虑到每个变量的重要性,结果以加权和非加权分数来衡量。除了使用间断时间序列外,还进行了预测分析和权重调整分析。时间序列包括实施前(6 个月)、实施期(3 个月)和实施后(6 个月)。由于天花板效应,预测分析采用了信息、包容和支持的中位数分数进行二分法。将实施期与实施后进行比较,发现亲属对危机管理的评价在统计学上存在显著的正差异[p = 0.009]。此外,从干预前到干预后,得分 >8 的概率在统计学上有显著增加 [风险比 1.21,95 % 置信区间 1.16-1.27]。次要结果显示,随时间推移变化最大的是纳入亲属[风险比 1.25,95% 置信区间 1.15-1.35]。信息对亲属对护士提供危机管理的体验影响最大,也是亲属认为最重要的需求领域。结论根据选定的临界值,干预措施似乎对亲属的体验产生了积极影响,尤其是对亲属的融入产生了积极影响。在加权分析中,信息被认为是最重要的,也对亲属的总体体验产生了最大的影响。创伤中心应优先考虑护士的危机管理能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
45
审稿时长
81 days
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