In the intensive therapy, there can be multiple factors that influence the overall health condition of patients. One of the problems that draw the attention of medical specialists is that patients in the intensive care unit may suffer from various symptoms and their negative effects at the time of treatment or after discharge. To simplify the understanding of these consequences and elaborate ways to manage them, the Society of Critical Care Medicine created the intensive care unit (ICU) liberation initiative.
According to Parrillo and Dellinger (2018), ICU liberation is “a quality improvement program geared toward reducing the symptoms of pain, agitation and delirium that threaten patient’s sense of self-worth and dignity” (p. 1150). The Society of Critical Care Medicine developed a range of certain measures and tools aimed at monitoring and eliminating the consequences mentioned above.
At the same time, many of the aspects that influence the success of intensive care still need careful consideration and research. One of them refers to indirect patient care and is connected with creating a safe and healthy environment for patients. This notion may include different elements, from controlling the temperature in patients’ wards to families’ involvement and its significance for patients’ recovery (Good & Kirkwood, 2017). In general, modern medicine does not give indirect care enough attention.
However, even though doctors and nurses spend much less time on indirect activities than on face-to-face interaction with patients and medical procedures, this type of care is essential for the treatment (Gallagher, 2019). In particular, managing patients’ environment is necessary for the overall well-being of patients, as inappropriate conditions may influence the major ICU liberation symptoms in a negative way.
Today, the majority of educational programs for healthcare workers accentuate different aspects of direct care. At the same time, according to Gallagher (2018), all staff should be aware of the possible negative influence of the hospital conditions on patients’ health. As doctors are mostly involved in direct patient care, the major responsibility for the safety of the environment lies with nurses, who are the target audience of the following project.
The plan that is going to be discussed further is primarily aimed at raising nurses’ awareness about how and why the patients’ environment should be controlled and properly managed. The educational program should be comprehensive and cover the full range of elements of the patient’s environment, as their proper management is a key factor in reducing symptoms and positively influencing recovery (Gallagher, 2018).
The lack of comprehensive training can create risks for patients in the intensive care unit connected with their physical and emotional state. Therefore, this issue should be studied and solved through the development of a special educational program for nurses.
The solution to the problem mentioned above is the development of a training course for nurses aimed at raising awareness about the importance of patients’ environment. The program should be created in the form of lectures with PowerPoint presentations, multimedia materials such as videos and audio recordings, and testing at the end of the educational course. Learning materials are to be focused on how to manage patients’ environment and why it is important for the ICU liberation. In order to improve the quality of the educational course, it is recommended to use real-life examples, case studies, and up-to-date scholarly sources.
The introductory lecture of the educational program focuses on the norms and regulations of a particular medical institution. According to Gallagher (2018), “all staff who work in a patient environment must be aware of and comply with local policies/guidance” (p. 193). These regulations and standards need to be clear and concise for their better understanding by medical personnel. Moreover, the aim of the first lecture is to demonstrate how negligence or insufficient attention paid to the patient’s environment may influence pain, agitation, and delirium. Therefore, the introductory presentation gives basic knowledge about the issue and its significance.
Further lectures are designed to give more detailed information about different aspects of managing the patients’ environment. Special attention should be paid to the decontamination of the reusable equipment. Gallagher (2018) emphasizes that not only patients but also other members of the hospital team can be affected by insufficient sanitation. Therefore, the responsible staff should understand that all the equipment needs to be properly sterilized prior to use or maintenance or repair procedures.
Another important objective of the educational program is to demonstrate that inappropriate conditions for patients may result in health deterioration even after ICU stay. For example, ignoring safety regulations may lead to the emergence of infections in patients after discharge (Gallagher, 2018). Therefore, the crucial role of infection prevention and control teams should be explained during the educational course. Moreover, the overall well-being of a patient may depend on the temperature in hospital rooms.
Good and Kirkwood (2017) mention that cold room temperatures may cause hypothermia and worsen a patient’s condition. They also emphasize the problem of metabolic acidosis, which can be “minimized by maintaining hemodynamic stability and adequate ventilation and oxygenation” (Good & Kirkwood, 2017, p. 535). The appropriate quality of air and its temperature may positively influence the level of agitation, as well as normalize patients’ sleep and provide physical comfort.
Finally, the patients’ social environment plays a vital role in the ICU liberation and, therefore, should also be specified in the educational program. According to the ICU liberation bundle, family engagement is one of the major conditions for the person under treatment (Parrillo & Dellinger, 2018). Nurses need to make sure that the patient’s family is fully informed about the health condition of the patient.
The benefit of family engagement is that the emotional satisfaction of patients reduces cardiovascular complications and provides the feeling of security (Family engagement and empowerment, n.d.). Moreover, a positive social environment and regular interaction with family reduce the level of agitation and anxiety.
Finally, the educational program should include the comprehensive testing of the nurses’ awareness of the patients’ environment management. The evaluation can be designed in the form of a questionnaire; both theoretical knowledge and practical implementation are to be assessed. Nurses need to demonstrate familiarity with the local principles of managing the patients’ environment. Upon completion of the course, medical staff should understand how inappropriate conditions in the intensive care unit influence pain, agitation, and delirium, and why it is important to control different aspects of the issue.
Evidence of Completion
Educational plan, PowerPoint presentations focused on the topics mentioned above, tests and reports aimed at evaluating the awareness of nurses about managing the patients’ environment.
Upon completion of the educational program, nurses will be able to manage the patients’ environment appropriately, which will eliminate the risk of environment-related negative effects in patients and positively influence their recovery.
Family engagement and empowerment. (n.d.). SCCM. Web.
Gallagher, R. (2019). The role of the nurse in decontamination. In J. Walker (Ed.), Decontamination in hospitals and healthcare (2nd ed., pp. 191-208). Woodhead Publishing.
Good, V.S., & Kirkwood, P.L. (Eds.). (2017). Advanced critical care nursing – E-book (2nd ed.). Elsevier Health Sciences.
Parrillo, J.E., & Dellinger, R.P. (2018). Critical care medicine E-book: Principles of diagnosis and management in the adult (5th ed.). Elsevier Health Studies.