Determination of families' needs of patients admitted in the intensive care unit (ICU) and the extent to which these needs are met as perceived by the family members and the icu nurses at Kenyatta National Hospital

Abstract

This was a descriptive cross sectional study carried out over a period of two and half months i.e. from mid May to July 2006. The purpose of the study was to determine families' needs of patients admitted in the Intensive Care Unit (ICU) and the extent to which these needs are met as perceived by patients' families and nurses working in ICU at the Kenyatta National Hospital (KNH). The data was collected from patients' family members and from the nurses working in the Intensive Care Unit. The Critical Care Family Needs Inventory (CCFNI) was used for data collection. This tool had thirty- nine (39) need statements with one additional open-ended question. The need statements were grouped into five domains i.e. information, assurance, support, proximity and comfort. A total of two hundred and eighty two (282) family members and eighty-four (84) nurses were recruited. Four (4) close family members of each patient in ICU were conveniently recruited and interviewed using the questionnaire while all the nurses available at the time of data collection filled the questionnaire. The data was analysed by use of computer software package for statistical solutions (SPSS). Presentation of data was done in tables, pie charts, column graphs, line graphs, means and percentages. Authority to carry out the study was given by the Kenyatta National Hospital Ethical Committee and the office of the president through the Ministry of Education. Among the 39 family needs expressed in the questionnaire, 37 (94.9%) were ranked by the family respondents as necessary while nurses ranked 34 (87.1%) as necessary. The need for information was ranked the most important followed by the needs for assurance, proximity, support and comfort in that order by the family respondents. The need for information was also ranked the most important by the nurses followed by the needs for assurance, support, comfort, and proximity in that order. There were significant differences (p<O.O1) in perception of the necessity and extent to which family needs are met amongst the families and amongst the nurses. It was concluded that families of patients admitted in the ICU have needs relating to information, assurance, proximity, support and comfort. The meeting of these needs falls below the expectation of the families and of the nurses at the Kenyatta National Hospital ICU hence compromising the quality of family centered nursing.' Some of the reasons contributing to low quality of family centered nursing were: low nurse: patient ratio, lack of written protocol for interacting with patients' families, lack of a conducive waiting room with adequate amenities for the patient's visitors. It's recommended that the families' needs identified and ranked in order of their perceived importance should be used in planning and implementing care for lCU patients and their families. This would also require adequate staff and a conducive environment for staff: patient: family interaction