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A qualitative study portraying nurses' perspectives on transitional care between intensive care units and hospitals wards

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@article{ff541ce9754c44fcbdd82536253b1f05,
title = "A qualitative study portraying nurses' perspectives on transitional care between intensive care units and hospitals wards",
abstract = "INTRODUCTION: The transition process from the intensive care unit (ICU) to hospital ward may impact the illness trajectory and compromise the continuity of safe care for ICU survivors. ICU and ward nurses are involved with the transition and are responsible for the quality of the transitional care.AIM: The aim was to explore ICU and ward nurses' views on assignments in relation to patients' transition between ICU and hospital ward.METHODS: We conducted a qualitative study with 20 semi-structured interviews with ICU nurses and ward nurses and analysed data by content analysis.SETTING: A university hospital with 690 beds and an 11-bed mixed medical/surgical ICU.FINDINGS: The overarching themes were (1) 'Ritual of hand over' with the categories: (a) 'Ready, able and willing', (b) 'Transfer of responsibility' and (c) 'Nice to know versus need to know' and (2) 'From lifesaving care to rehabilitative care' with the categories: (a) 'Complex care needs persist', (b) 'Fight or flight mode' and (c) '{"}Weaning{"} the family'. Nurses were highly focused on the ritual of the actual handover of the patient and discussed readiness as an indicator of quality and the feeling of passing on the responsibility. Nurses had different opinions on what useful knowledge was and thus necessary to communicate during handover. Although patients' complex care needs may not have been resolved when exiting the ICU, ward nurses had to receive patients in a setting where nurses were mostly comfortable within their own specialty - this was worrying for both type of nurses. Patients could enter the ward very exhausted and weak or in 'fight mode' and demand rehabilitation at a pace the ward was not capable of delivering. ICU nurses encouraged families to be demanding after the ICU stay, and ward nurses asked them to trust them and steep back.",
keywords = "applied research, content analysis, critical care, handover, intensive care unit, interprofessional, organisation, qualitative, transition",
author = "Herling, {Suzanne Forsyth} and Helene Brix and Lise Andersen and Jensen, {Liz Daugaard} and Rie Handesten and Heidi Knudsen and Bove, {Dorthe Gaby}",
note = "{\textcopyright} 2021 Nordic College of Caring Science.",
year = "2021",
month = apr,
day = "28",
doi = "10.1111/scs.12990",
language = "English",
journal = "Scandinavian Journal of Caring Sciences",
issn = "0283-9318",
publisher = "Wiley-Blackwell Publishing Ltd",

}

RIS

TY - JOUR

T1 - A qualitative study portraying nurses' perspectives on transitional care between intensive care units and hospitals wards

AU - Herling, Suzanne Forsyth

AU - Brix, Helene

AU - Andersen, Lise

AU - Jensen, Liz Daugaard

AU - Handesten, Rie

AU - Knudsen, Heidi

AU - Bove, Dorthe Gaby

N1 - © 2021 Nordic College of Caring Science.

PY - 2021/4/28

Y1 - 2021/4/28

N2 - INTRODUCTION: The transition process from the intensive care unit (ICU) to hospital ward may impact the illness trajectory and compromise the continuity of safe care for ICU survivors. ICU and ward nurses are involved with the transition and are responsible for the quality of the transitional care.AIM: The aim was to explore ICU and ward nurses' views on assignments in relation to patients' transition between ICU and hospital ward.METHODS: We conducted a qualitative study with 20 semi-structured interviews with ICU nurses and ward nurses and analysed data by content analysis.SETTING: A university hospital with 690 beds and an 11-bed mixed medical/surgical ICU.FINDINGS: The overarching themes were (1) 'Ritual of hand over' with the categories: (a) 'Ready, able and willing', (b) 'Transfer of responsibility' and (c) 'Nice to know versus need to know' and (2) 'From lifesaving care to rehabilitative care' with the categories: (a) 'Complex care needs persist', (b) 'Fight or flight mode' and (c) '"Weaning" the family'. Nurses were highly focused on the ritual of the actual handover of the patient and discussed readiness as an indicator of quality and the feeling of passing on the responsibility. Nurses had different opinions on what useful knowledge was and thus necessary to communicate during handover. Although patients' complex care needs may not have been resolved when exiting the ICU, ward nurses had to receive patients in a setting where nurses were mostly comfortable within their own specialty - this was worrying for both type of nurses. Patients could enter the ward very exhausted and weak or in 'fight mode' and demand rehabilitation at a pace the ward was not capable of delivering. ICU nurses encouraged families to be demanding after the ICU stay, and ward nurses asked them to trust them and steep back.

AB - INTRODUCTION: The transition process from the intensive care unit (ICU) to hospital ward may impact the illness trajectory and compromise the continuity of safe care for ICU survivors. ICU and ward nurses are involved with the transition and are responsible for the quality of the transitional care.AIM: The aim was to explore ICU and ward nurses' views on assignments in relation to patients' transition between ICU and hospital ward.METHODS: We conducted a qualitative study with 20 semi-structured interviews with ICU nurses and ward nurses and analysed data by content analysis.SETTING: A university hospital with 690 beds and an 11-bed mixed medical/surgical ICU.FINDINGS: The overarching themes were (1) 'Ritual of hand over' with the categories: (a) 'Ready, able and willing', (b) 'Transfer of responsibility' and (c) 'Nice to know versus need to know' and (2) 'From lifesaving care to rehabilitative care' with the categories: (a) 'Complex care needs persist', (b) 'Fight or flight mode' and (c) '"Weaning" the family'. Nurses were highly focused on the ritual of the actual handover of the patient and discussed readiness as an indicator of quality and the feeling of passing on the responsibility. Nurses had different opinions on what useful knowledge was and thus necessary to communicate during handover. Although patients' complex care needs may not have been resolved when exiting the ICU, ward nurses had to receive patients in a setting where nurses were mostly comfortable within their own specialty - this was worrying for both type of nurses. Patients could enter the ward very exhausted and weak or in 'fight mode' and demand rehabilitation at a pace the ward was not capable of delivering. ICU nurses encouraged families to be demanding after the ICU stay, and ward nurses asked them to trust them and steep back.

KW - applied research

KW - content analysis

KW - critical care

KW - handover

KW - intensive care unit

KW - interprofessional

KW - organisation

KW - qualitative

KW - transition

UR - http://www.scopus.com/inward/record.url?scp=85105370823&partnerID=8YFLogxK

U2 - 10.1111/scs.12990

DO - 10.1111/scs.12990

M3 - Journal article

C2 - 33908642

JO - Scandinavian Journal of Caring Sciences

JF - Scandinavian Journal of Caring Sciences

SN - 0283-9318

ER -

ID: 66402664