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dc.contributor.authorRose, Louise
dc.contributor.authorIstanboulian, Laura
dc.contributor.authorAllum, laura
dc.contributor.authorDale, C
dc.contributor.authorKydonaki, Claire
dc.contributor.authorRamsay, Pam
dc.contributor.authorPattison, Natalie
dc.contributor.authorConnolly, Bronwen
dc.contributor.authorPERFORM study investigators
dc.date.accessioned2020-11-13T11:45:02Z
dc.date.available2020-11-13T11:45:02Z
dc.date.issued2019-04-01
dc.identifier.citationRose , L , Istanboulian , L , Allum , L , Dale , C , Kydonaki , C , Ramsay , P , Pattison , N , Connolly , B & PERFORM study investigators 2019 , ' Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review ' , Critical Care Expectations , vol. 1 , no. 4 , e0005 . https://doi.org/10.1097/CCE.0000000000000005
dc.identifier.issn2639-8028
dc.identifier.otherPURE: 17176667
dc.identifier.otherPURE UUID: a1000c29-fa66-4a81-a92a-bd045d5bd5b5
dc.identifier.urihttp://hdl.handle.net/2299/23450
dc.description© 2019 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY-NC-ND - https://creativecommons.org/licenses/by-nc-nd/4.0/), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
dc.description.abstractObjectives: To identify actionable processes of care, quality indicators, or performance measures and their evidence base relevant to patients with persistent or chronic critical illness and their family members including themes relating to patient/family experience. Data Sources: Two authors independently searched electronic, systemic review, and trial registration databases (inception to November 2016). Study Selection: We included studies with an ICU length of stay of greater than or equal to 7 days as an inclusion criterion and reported actionable processes of care; quality improvement indicators, measures, or tools; or patient/family experience. We excluded case series/reports of less than 10 patients. Data Extraction: Paired authors independently extracted data and performed risk of bias assessment. Data Synthesis: We screened 13,130 references identifying 114 primary studies and 102 relevant reviews. Primary studies reported data on 24,252 participants; median (interquartile range) sample size of 70 (32–182). We identified 42 distinct actionable processes of care, the most commonly investigated related to categories of 1) weaning methods (21 studies; 27 reviews); 2) rehabilitation, mobilization, and physiotherapy (20 studies; 40 reviews); and 3) provision of information, prognosis, and family communication (14 studies; 11 reviews). Processes with limited evidence were generally more patient-centered categories such as communication, promotion of sleep, symptom management, or family support. Of the 21 randomized controlled trials, only two were considered at low risk of bias across all six domains, whereas just two cohort studies and one qualitative study were considered of high quality. Conclusions: We identified 42 distinct actionable processes of care relevant to patients with persistent or chronic critical illness and their families, with most frequently studied processes relating to weaning, rehabilitation/mobilization, and family communication. Qualitative studies highlighted the need to address psychologic needs and distressing symptoms as well as enabling patient communication. Our findings are informative for clinicians and decision-makers when planning high-quality patient and family-focused care.en
dc.format.extent11
dc.language.isoeng
dc.relation.ispartofCritical Care Expectations
dc.titlePatient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Reviewen
dc.contributor.institutionSchool of Health and Social Work
dc.description.statusPeer reviewed
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1097/CCE.0000000000000005
rioxxterms.typeOther
herts.preservation.rarelyaccessedtrue


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