Meeting patient and relatives' information needs upon transfer from an intensive care unit: the development and evaluation of an information booklet

Abstract

Background: Transfer from the intensive care unit to a ward is associated with a significant degree of relocation stress for patients and relatives. This can be stressful for ward nurses due to the dependency levels of patients and the ensuing increased workload. Furthermore the patient may require care, not normally undertaken in that clinical area, e.g. tracheostomy care. Patients may forget the verbal information given to them at the time of transfer and often have limited or no memory of the intensive care unit experience. This can cause anxiety and compound the feelings of stress associated with transfer. Many patients suffer psychological and physiological problems after intensive care unit, which can affect their recovery and quality of life.

Aims: The aim of the study was to develop an evidence-based information booklet for patients and relatives preparing for transfer from intensive care units.

Design: This collaborative study used an exploratory design with elements of the action research cycle. The study, conducted in three phases, involved identifying patients' and relatives' information needs around the time of transfer; designing and developing an information booklet; and the introduction and evaluation of the booklet into practice.

Methods: Semistructured interviews were used to elicit the views of patients and relatives regarding their information needs. Members of the multidisciplinary team were involved in identifying and reviewing booklet content.

Results: Evaluation identified positive outcomes relating to patients' and relatives' satisfaction with the information and enhanced communication with other wards and health care professionals. The study also highlighted the need for more staff education in relation to patients and relatives needs when transferring to a ward.

Conclusions: This study has demonstrated the value of providing patients and relatives with written information regarding transfer from intensive care units. Furthermore the study confirmed the feasibility and importance of including patients and relatives in the process of booklet development to ensure that their needs for information are being met.

Relevance to clinical practice: Providing written information as part of a structured discharge plan is recommended. It provides patients and relatives with a resource that they can refer to at any time and that enhances verbal communication. The purpose of this information is to inform and empower patients so that they are better prepared for the transfer and recovery period.