Intensive care clinician attitudes and perceptions towards whānau participation in adult intensive care bedside ward rounds in Aotearoa New Zealand: An online survey.

Abstract

Background: Clinical practice guidelines endorse family involvement in ward rounds to improve communication and engagement between patients, whānau (family), and healthcare teams, yet the practice has not been universally implemented. Whānau inclusion in adult bedside rounds is often met with hesitation by intensive care unit (ICU) healthcare clinicians, and reasons for this have not been explored in Aotearoa, New Zealand.

Objectives: The aim of this study was to assess attitudes and perceptions of ICU clinicians towards whānau-family inclusion in adult ICU ward rounds in Aotearoa New Zealand.

Methods: A national, prospective, cross-sectional survey using a self-administered online questionnaire was distributed to three metropolitan ICUs in Aotearoa, New Zealand, and members of the New Zealand College of Critical Care Nurses and the College of Intensive Care Medicine of Australia and New Zealand in the period July-December 2020.

Results: In total, 188 ICU physicians, nurses, and allied health professionals responded. Over half of respondents strongly (23.4%) or somewhat agreed (29.3%) that whānau-family members should be given the option to attend bedside rounds, whereas more than half reported having had a positive experience when whānau-family had been present on rounds. Less experienced nurses were more likely to ask whānau-family to leave during rounds than more experienced nurses (46.5% vs 38.2%, respectively, p = 0.006). Clinicians voiced concern that whānau-family inclusion would prolong rounds, reduce teaching opportunities, constrain discussion of sensitive information, and compromise patient confidentiality. However, they also said that whānau-family-centred rounds were useful to better inform whānau-family members and to facilitate culturally safe practice.

Conclusion: Intensive care clinicians demonstrated positive attitudes and perceptions towards whānau-family-centred ward rounds, but concerns regarding the structure and quality of rounds were raised. Clinicians recognise whānau-family-centred rounds as an opportunity to enhance communication and facilitate culturally safe practice. Education regarding the benefits of whānau-family-centred rounds to facilitate implementation is required.