The patient-centered intensive care unit (ICU) approach is focused on the interests of patients and their families and opposes the traditional way of delivering healthcare. While traditional healthcare generally limits families’ abilities to visit their loved ones who are in the ICU, patient-centered care (PCC) strives for more open access for relatives and more flexible communication strategies among patients, relatives, and healthcare personnel. The successful application of the model that Riley, White, Graham, and Alexandrov (2014) analyze depends on understanding the problems that ICUs may face during the implementation of the patient-centered paradigm as well as on assessing the model’s execution. In the professional nursing context, the PCC method can improve the levels of satisfaction of all involved parties – patients, family members, nurses, and physicians – and contribute to the professional development of the nurses. In a broader healthcare context, the PCC approach is a step in the right direction for significant change in ICU practices and “self-governance of health-care” (Riley et al., 2014, p. 317).
The existing protocol in many healthcare environments restricts the access of patients’ family members to ICUs, which many patients and their relatives consider to be a significant limitation of their rights, including the right to be informed about the condition of a treated person. On the other hand, many nurses consider the recent ICU initiatives to primarily facilitate patients’ interests. The introduction of the PCC approach has divided healthcare professionals into those who are skeptical of the practice, “stating that open visitation would detract from patient care” (Riley et al., 2014, p. 317) and would increase ICU staff workload, and those who consider the PCC method as a way of better serving the interests of patients and their relatives. The Riley et al. (2014) study indicates that a significant number of nursing professionals are more responsive to a combination of the traditional way of ICU work and the newer PCC model (Riley et al., 2014, p. 320). Concerning the level of expertise, the nurses who provide open information about the patients’ conditions and who are open to the needs of both the patients and their families are regarded by relatives as more professional in comparison with the healthcare personnel who follow the traditional ICU approach.
Insufficient communication is another barrier that all involved parties must deal with. From the families’ perspective, the PCC model improves the issue of interaction because nurses are more available and cooperative in informing them about patient progress. The findings by Riley et al. (2014) demonstrate an improvement in the effectiveness of nurse-patient interaction with the employment of the PCC model and with the involvement of communication facilitators; as the authors report, “ratings by patients’ families of satisfaction with ICU team contact were increased by the addition of a family support person” (Riley et al., 2014, p.322). Barry and Edgman-Levitan (2012) support such an open approach to interaction with patients by advocating the concept of “decision aids” and cooperation between the physicians and nurses who can provide detailed information to patients and their families about treatment. Moreover, this open method motivates the patients to share their concerns about the outcomes of the treatment (Barry & Edgman-Levitan, 2012, p.781).
Further examination by Riley et al. (2014) reveals that growth in the professionalism of nurses is linked to patients’ and relatives’ satisfaction with treatment and care, which increases with the implementation of the PCC program. The positive outcomes associated with the PCC method include an improvement in communication between medical professionals as well. Furthermore, it has been found that nurse anxiety about the potential for an increased workload is unnecessary (Riley et al., 2014, p. 322).
The implementation of the PCC model in ICUs contributes to an improvement in communication, trust, and confidence in the relationships between patients, their families, and nurses. The obstacles that may be faced (e.g., the rigidness of nurses and their adhesion to more traditional ICU practices) are outweighed by the many proven benefits of the PCC practice. The development of a healthcare system associated with the application of the PCC model enhances the delivery of care, the professionalism of the staff, and the satisfaction of patients, relatives, and medical care providers.
Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781.
Riley, B. H., White, J., Graham, S., & Alexandrov, A. (2014). Traditional/restrictive vs. patient-centered intensive care unit visitation: perceptions of patients’ family members, physicians, and nurses. American journal of critical care, 23(4), 316-324.