(784) Family Members as Active Participants in ICU Care While Performing Passive Range-of-Motion Exercises

Introduction: Patient and family-centered care includes involving family members in interventions to support patient care. The ICU Liberation bundle includes early mobility and family member involvement. Literature on family involvement in passive range of motion exercises (PROM) specifically is limited. We aimed to determine the satisfaction of family members who performed PROM exercises on critically ill patients. We hypothesized family members would provide valuable feedback to support involving family members in performing PROM exercises.

Methods: A prospective, descriptive, survey and mixed methods design was used. Family members were taught PROM exercises by investigators. A poster showing methods to perform PROM exercises and exercise log for documenting performance were hung in the patient’s room for reference. Investigators made clinical rounds to reinforce PROM activities. The Family Perception of PROM survey developed for this study included 8 questions with a 5-point Likert scale. Reliability testing of tool yielded a Cronbach alpha 0.736. Results were analyzed with descriptive statistics and included a section for open-ended comments, which was evaluated using thematic analysis.

Results: Twenty-four family members participated; n=9 (38%) completed surveys. Mean scores of questions related to satisfaction with PROM: participation in care, purpose, comfort and support of the family and patient were 4.82/5and questions about feeling anxious, scared, or potentially causing harm 3.89/5 with 2 subjects indicating fear of harm. Mean total scores were 40.6/45. Thematic analysis of comments revealed families felt a sense of purpose, participation in care, various emotions related to participation, and feeling support for the patient and family while performing PROM. A challenge for some family members was the uncertainty of the illness trajectory of the patient while in the ICU.

Conclusions: Survey results confirmed that family members expressed high satisfaction and appreciation for involvement with PROM exercises. When teaching family members about performing PROM, attention to addressing potential fears of causing harm is important. Overall, PROM exercise performed by family is a viable option to support patient and family-centered care while in the ICU and can be proposed to other clinical settings.