Perspectives of Intensive Care patients and family members on competencies for Advanced Intensive Care nurses in Europe

Christina Jones, M. Peskett, P. Ramsay, R. Endacott, A. Xyrichis, K. Iliopoulou
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Abstract

Background One output from the International Nursing Advanced Competency-based Training for Intensive Care (INACTIC) collaboration is a set of core competencies for advanced practice Intensive Care Unit (ICU) nurses across Europe. Some European countries, such as the UK, have identified such competencies, however, these advanced practice roles are rarely practiced across the rest of Europe. The INACTIC competencies were developed with an expert panel of 184 ICU nurses from 20 countries. It is also important to examine what patients and relatives with experience of intensive care felt about these competencies.   Aim To examine the views of recovered ICU patients and relatives regarding the INACTIC competencies. Methods Three patient and relative focus groups were conducted in England (n=5), Scotland (n=4) and Greece (n=4) to discuss a lay version of the INACTIC competencies. Discussions were open ended, followed a topic guide, recorded and transcribed verbatim. Analysis followed a conventional thematic approach, with the findings discussed iteratively among the authors. Results The feedback from across the focus groups resulted in three themes: 1) the importance of nurses being empowered to advocate for the patient; 2) the centrality of communication; and, 3) the impact of variability in ICU practices. There was a notable difference with the Greek focus group; because of restricted family visiting policies, relatives did not feel encouraged to participate in patient care. Conclusions The perspectives of patients and relatives largely aligned with the consensus of the INACTIC expert panel. Local differences in ICU experience highlight the changes that some ICUs would need to make for the INACTIC competencies to be embedded.
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重症监护病人和家庭成员对欧洲高级重症监护护士能力的看法
国际护理高级能力为基础的重症监护培训(INACTIC)合作的一个成果是一套核心能力,适用于整个欧洲的高级重症监护病房(ICU)护士。一些欧洲国家,如英国,已经确定了这些能力,然而,这些高级实践角色很少在欧洲其他国家得到实践。INACTIC能力是由来自20个国家的184名ICU护士组成的专家小组制定的。检查有重症监护经验的患者及其亲属对这些能力的感受也很重要。目的探讨ICU康复患者及其家属对INACTIC能力的看法。方法在英国(n=5)、苏格兰(n=4)和希腊(n=4)进行了3个患者和相关焦点小组的研究,讨论了INACTIC能力的外行版本。讨论是开放式的,按照主题指南进行,并逐字记录和抄本。分析遵循传统的主题方法,作者之间反复讨论研究结果。结果各焦点小组的反馈产生了三个主题:1)护士被授权为患者辩护的重要性;2)沟通的中心性;3) ICU实践中可变性的影响。希腊焦点小组的结果有显著差异;由于受限制的探亲政策,家属不愿意参与病人护理。结论患者和家属的观点与INACTIC专家组的共识基本一致。ICU经验的地方差异突出了一些ICU需要做出的改变,以便嵌入INACTIC能力。
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