(787) Nurses’ Role in Transitional Care Planning During ICU Family Meetings

Introduction: After the intensive care unit (ICU), patients with prolonged mechanical ventilation (PMV) and their families are likely to experience multiple transitions in the location or level of their care. Nurses play a crucial role in planning these transitions, particularly during family meetings. Yet, there are no ICU transitional care (TC) standards in the United States, and research to guide TC planning is limited. Despite their clinical expertise, nurses feel their perspectives are not fully recognized in these family meetings and their significant time and support for families are often unrecognized. The purpose of this study was to describe nurses’ role related to TC planning in ICU family meetings.

Methods: We used a qualitative descriptive design with secondary data purposively sampled from a trial of a decision aid about PMV. Among the 19 unstructured ICU family meeting transcripts where nurses were involved, we explored nurses’ role and nurse engagement related to TC using directed content analysis. Predetermined codes were developed from the literature on nurse-family communication during ICU family meetings, including strategies and characteristics of nurse engagement.

Results: The transcripts from 19 family meetings of 19 unique patients and their 19 primary family members, along with 12 nurses, were analyzed. In only 25% of family meetings in which TC topics were discussed, nurses engaged in the discussion beyond their introduction. Three themes were identified describing the roles nurses served: 1) information and communication facilitators (e.g., moderating family meetings, facilitating family understanding, serving as communication intermediaries), 2) family support providers (e.g., providing emotional support, describing expectations, advocating for patients/families), and 3) TC liaisons (e.g., introducing next levels of care, identifying/engaging family members, providing patient/family education, and more).

Conclusions: The findings of this study have practice implications for increasing nurse engagement in TC planning during family meetings providing information and coaching to help patients/families navigate care transitions early in the treatment continuum. Future research and development of TC standards are essential to guide nurses’ role in ICU TC planning.