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Putting care into ICU stays

Fuseworks Media
Fuseworks Media

For most patients admitted to an intensive care unit (ICU) in New Zealand their stay is short, however, as a consequence of advances in life-sustaining therapies a new group of patients has emerged. Surviving their initial critical illness, these patients become dependent on life-sustaining interventions for a prolonged period.

Dr Claire Minton, a lecturer at Massey University’s School of Nursing, explored the experiences of patients, their families and healthcare professionals during the trajectory of a prolonged critical illness, for her PhD thesis. Her research provides insights into the complexity of care during prolonged critical illness, which can result in interventions, education and research targeted to improve outcomes and experiences.

Dr Minton examined this from the viewpoint of the patient, their family and healthcare professionals who provided care throughout their illness, while in the ICU. She graduated with her Doctor of Philosophy in Palmerston North yesterday.

"Some patients in this study were in the ICU for more than 60 days - their illness left them physiologically debilitated and psychologically fragile," Dr Minton says. "It took them months to rehabilitate in hospital and at home after their illness. The burden of a prolonged critical illness on their family was enormous as they managed uncertainty related to the illness outcome, undertook hospital visits for weeks to months and their ability to manage everyday responsibilities despite all of this, was profound."

This study also highlighted the complexities in clinical practice. "This research highlighted the complexity nurses face every day at work, as they navigate a complex group of patients that need a lot of nursing, in an environment that can be unsuitable and in a model of care that focuses on acute not chronic care. With only finite resources in New Zealand for ICU services, nurses do an amazing job at supporting these patients and their families during a prolonged period of difficulty," she says.

The findings from this study are important for the speciality of intensive care internationally, Dr Minton says. "It identified common issues for patients as they progress through during their critical illness, which can set the ground work for interventions targeted to specific stages of the illness to improve outcomes for patients and their family. This study can inform further research targeted to specific stages of a prolonged critical illness to continue to grow this body of knowledge, in which there is limited research within New Zealand and internationally.

"As this study included the experiences of family throughout a prolonged critical illness the findings can inform interventions to assist family throughout their journey which was dominated by great uncertainty.

This study will also assist nurses working in the ICU to understand the complexity of care and inform new models of care for this patient group," Dr Minton says.

Dr Minton, who lives in Palmerston North with her husband Carl and two daughters Ella (14) and Holly (12), has been a registered nurse since 1988. She holds a Diploma of Nursing from the former Manawatū Polytechnic and in 2003, she gained her Masters of Nursing from Massey. She has worked as an intensive care nurse for many years before she came to Massey.

Dr Minton is now involved as clinical lead for the Bachelor of Nursing programme at Massey across all three campuses and she is course coordinator for undergraduate acute illness papers and clinical practice.

"I’m delighted to be graduating with the students I taught last year and my PhD journey continues to inform my teaching and research to improve outcomes for patients and their family through dissemination of research findings, but also through the students we teach."

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