Tele-ICU as an Adjunct to Care:
The Family Voice
2011 Maine Nursing Summit, April 5, 2011
‘Planning for the Future’
Susan Flewelling Goran, MSN, RN
Director, MaineHealth VitalNetwork
Traditional ICU: Understanding the Needs
of the Family
• Feel hope
• Feel that clinicians care
about the patient
• Be allowed to see the
patient frequently; be
called about changes in
the patient condition
• Know the prognosis
• Know specific facts about
the prognosis
• Have questions
answered honestly
• Receive information
about the patient daily
• Have explanations given
in understandable terms
Molter, Heart & Lung 8:332-339,1979.
Utilization of sophisticated telemedicine technology
and a remote team of critical care experts to provide
continuous monitoring, assessment, and
interventional services to a large number of patients
across geographically disparate ICUs.
3
What about the patients and families?
• Are we providing the
information that is most
important to them?
– Brochures
– Posters in the waiting room
– Website information
• How do they feel about the
tele-ICU?
How can we answer the questions?
• Family Perceptions of
e-ICU: A Multi-site
Collaborative Study
the
• PRINCIPAL INVESTIGATOR
– Mary Jahrsdoerfer, MS, RN,
PhD(c)
– Doctoral Student- University
of Massachusetts Amherst
• CO-INVESTIGATOR
– Susan F. Goran, MSN, RN
– MaineHealth VitalNetwork;
Operations Director
• Western MA Academic
Center
• Tertiary Care Center
Southern Maine
• Tertiary & Community Care
System Midwest
Research Design
 Descriptive study using a convenience sample
 A survey tool distributed/collected during the patient’s
hospital admission
 The package was distributed by volunteers (non-ICU
staff) to family members within the immediate vicinity
of the ICU
 The packet consisted of three distinct pages
 Demographic page (pre-filled)
 Letter of consent
 Survey questionnaire: 6 questions, 1 open-ended
Do You have 10 Minutes?
Your feedback is important
to us!
Please ask our volunteers if you wish to
complete a survey about your visitation
experience. You must be over 18 years
of age, and able to read and speak
English to participate.
If no volunteer is available, please check
back another time.
Thank You!
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Demographics
• N = 198 (66% return rate 198/300)
• Type of center: 51% tertiary, 11%
academic, 38% community
• Unit size: 58% 7-12 beds, 36% > 12
beds
• Type of Unit: 46% Med-Surg
Mixed, 52% specialty ICUs (Neuro,
Cardiovascular, etc.)
Have you received any information about
the eICU?
65 /34%
132 /66%
Yes
No
31 Family Members
How Would You Like to Receive
Information?
98 respondents (50%) prefer to receive the
information by talking with the ICU nurse.
What type of information would you
like to have about the eICU?
Answer all that apply
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How do you feel about the eICU?
88 (~45% response)
Positive
2%
N=2
Negative
19%
N = 19
Neutral
79%
N = 69
Response Trends
Comfort
Technology
Safety/Quality
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The Voice of the Family: The Positive (79%)
Comfort
 A relief to know so many
people are looking after my
husband
 Feel good that while I am
gone staff knows what is
happening with my loved one
 Knowing that someone is
watching is comforting
Technology
 Glad my hospital has this type
technology
 Important advancement to
health care
Safety/Quality
 Anything that helps ensure
quality care is valuable as long
as it does not get in the way of
real time decision making
 Good to know the patient is
safe
 Valuable to have another
person monitoring my spouses’
vital information to insure that
nothing inadvertently gets
overlooked
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The Voice of the Family: Other Feedback
Negative: (2%)


I am not a big fan of surveillance
I would prefer my grandpa have person to person care
rather than speaking to someone via camera
Neutral: (19%)



Didn’t know anything about it
Need more information before I can answer
I wasn't told, but I saw a camera in room, so more
information about this would be appreciated
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Implications for Future Practice
 Staff Education
 Importance of information directly from the nurse
 Family desire for information, especially when cameras are
visible
 Connect the relationship of the eICU to the potential of cost
reductions by moving patients safely and quickly through the
ICU and hospital
 Patient / Family Education
 Finding the right mix: method and information
 Expanding the research
 Video visitation ?
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Planning for the Future