A critical care admission can be very traumatic to both patients and their families, with the effects of physical impairments and psychological stress being experienced sometime after discharge which can impede daily life. Research suggests that a critical care support group that connects critical care survivors and their families with others who have also experienced critical care may allow them to share, discuss and work together to overcome these impairments so to improve overall quality of life for patients and their families. Medway NHS Foundation Trust commenced a critical care support group in June 2019 led by a rehabilitation nurse, physiotherapist and counsellor, but attendance numbers were low. The aim of this project was to increase uptake of former patients and their families by a factor of two, in comparison to September 2019, at Medway Maritime Hospital by Feb 2020 and to review patient satisfaction.
PDSA cycles were used as a method for quality improvement within this setting. To establish a baseline the first PDSA cycle asked former critical care patients via a questionnaire if they were aware of the support group and if they had attended if satisfaction was reviewed. Other measures included recording the number of attendees at each monthly meeting. This first cycle highlighted a lack of awareness of the critical care support group, so information leaflets were designed and distributed to all critical care patients in cycle two. Additionally, in cycle three, posters advertising the support group were displayed on the critical care unit and family areas.
Results: Results demonstrated that after releasing the leaflets, attendance increased from 4 to 13 attendees per month, and after introducing posters this went up to 18 which included more family members. In respect to satisfaction; patients and families reported that they found the forum of the support group to be an open and honest place for discussion but there was some concerns over the location at the hospital as some individuals found it difficult to return. An alternative location is now being sought. There were also themes around concerns and anxieties so moving forwards, relevant professionals such as dietitians, speech and language therapy, disablement services and information regarding financial services are being introduced.
Conclusion(s): The introduction of an information leaflet, supplemented by poster advertisement is an effective way of increasing participation of critical care survivors and their families to a peer support group. The addition of educational speakers and affiliation to ICU Steps will further enhance on-going attendance. To maintain a consistent attendance, a regular newsletter will now be distributed advertising future events and the support group will be affiliated to ICU steps. Further investigation is required to establish why patients do not attend the support group or cease to attend after several months.
Cost and savings
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The project highlights the value a patient support group has on post-ICU care for survivors, as seen from feedback from attendees, and that attendance to the groups can be bolstered by relatively simple measures.
Top three learning points
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Medway NHS Foundation Trust