Objective:
To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU.
Methods:
We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis, and family-centered care to revise the 2007 Clinical Practice Guidelines for support of the family in the patient-centered ICU. We conducted a scoping review of qualitative research that explored family-centered care in the ICU. Thematic analyses were conducted to support Population, Intervention, Comparison, Outcome question development. Patients and families validated the importance of interventions and outcomes. We then conducted a systematic review using the Grading of Recommendations, Assessment, Development and Evaluations methodology to make recommendations for practice. Recommendations were subjected to electronic voting with pre established voting thresholds. No industry funding was associated with the guideline development.
Results:
The scoping review yielded 683 qualitative studies; 228 were used for thematic analysis and Population, Intervention, Comparison, Outcome question development. The systematic review search yielded 4,158 reports after deduplication and 76 additional studies were added from alerts and hand searches; 238 studies met inclusion criteria. We made 23 recommendations from moderate, low, and very low level of evidence on the topics of: communication with family members, family presence, family support, consultations and ICU team members, and operational and environmental issues. We provide recommendations for future research and work-tools to support translation of the recommendations into practice.
Conclusions:
These guidelines identify the evidence base for best practices for family-centered care in the ICU. All recommendations were weak, highlighting the relative nascency of this field of research and the importance of future research to identify the most effective interventions to improve this important aspect of ICU care.

The case for adopting the 3M TegadermCHGIV securement dressing for central venous and arterial catheter insertion sites is supported by the evidence. This technology allows observation, and provides antiseptic coverage, of the catheter insertion site. It reduces catheter-related bloodstream infections and local site infections compared with semipermeable transparent (standard) dressings. It can be used with existing care bundles.
The 3M TegadermCHGIV securement dressing should be considered for use in critically ill adults who need a central venous or arterial catheter in intensive care or high dependency units.
The estimated cost saving from using a 3M Tegaderm CHGIV securement dressing (TegadermCHG) instead of a standard transparent semipermeable dressing is £93 per patient. This estimate is based on a baseline catheter-related bloodstream infection rate of 1.48 per 1,000catheter days. Tegaderm CHG is estimated to be cost neutral when the baseline catheter-related bloodstream infection rate is 0.18 per 1,000catheter days, and cost incurring when the baseline rate falls below that figure. [2019 – see section[2019 – see section5.25] 5.25]

The case for adopting the 3M TegadermCHGIV securement dressing for central venous and arterial catheter insertion sites is supported by the evidence. This technology allows observation, and provides antiseptic coverage, of the catheter insertion site. It reduces catheter-related bloodstream infections and local site infections compared with semipermeable transparent (standard) dressings. It can be used with existing care bundles.
The 3M TegadermCHGIV securement dressing should be considered for use in critically ill adults who need a central venous or arterial catheter in intensive care or high dependency units
The estimated cost saving from using a 3M TegadermCHGIV securement dressing (TegadermCHG) instead of a standard transparent semipermeable dressing is £93 per patient. This estimate is based on a baseline catheter-related bloodstream infection rate of 1.48 per 1,000catheter days. TegadermCHG is estimated to be cost neutral when the baseline catheter-related bloodstream infection rate is 0.18 per 1,000catheter days, and cost incurring when the baseline rate falls below that figure.