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Patient and family* engagement in the ICU is an active partnership between health professionals and patients and families working at every level of the healthcare system to improve health and the quality, safety, and delivery of healthcare. Arenas for such engagement include but are not limited to participation in direct care, communication of patient values and goals, and transformation of care processes to promote and protect individual respect and dignity. PFE comprises five core concepts: Collaboration, Respect and Dignity, Activation and Participation, Information Sharing, and Decision Making

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This guide is to help family and friend of the ICU patients to identified if the patients had delirium and how to help them.

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Delirium has been previously described as a syndrome of organ dysfunction involving the central nervous system. The prevalence of delirium in the ICU varies from 20-80%. Delirium has been associated with increased hospital length of stay, duration of mechanical ventilation, and mortality. Sedative and narcotic use has been shown to increase the risk and severity of delirium. Haloperidol is the mainstay of delirium management as recommended by the Society of Critical Care Medicine (SCCM) due to extensive clinical experience with this medication. However, its usage is often limited by safety concerns. Atypical antipsychotics such as quetiapine have been shown to have equivalent success in the treatment of delirium while being associated with fewer side effects.

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The delirium protocol helps the medical practitioner to perform Delirium assessment via CAM-ICU

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Delirium is a medical condition that increases length of stay, risk of death, functional decline, healthcare cost, caregiver burden, and impaired quality of life. The Delirium Toolbox is low-cost, efficient option of non-pharmacological tools to use in delirium prevention and management.

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Delirium Tools Derived from the Confusion Assessment Method

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Objectives:
• Define delirium and manifestations
• Discuss the impact of delirium on patient outcomes
• Review tools to measure delirium
• Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Intensive Care Delirium Screening Checklist (ICDSC)
• Identify strategies to build an ICU attentive to delirium
• Examine general principles, non-pharmacologic and pharmacologic interventions for the management of delirium

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This document outlines British Thoracic Society (BTS) guidance on the adaptation of pulmonary rehabilitation to meet the recovery needs of the post COVID-19 patient.

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THURSDAY, May 7, 2020 (HealthDay News) -- The ordeal faced by critically ill COVID-19 patients likely won't end even if they pull through and survive their life-threatening infection, experts fear. Some of these survivors will be emotionally scarred by their time spent in an intensive care unit (ICU), and they are at increased risk of psychological problems, such as anxiety, depression and post-traumatic stress disorder (PTSD).

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Background: Admission of a patient in the Intensive Care Unit (ICU) and the recovery process may be stressful for family members.

Objectives: This study aimed to explore the families' psychological symptoms and their evolution over the 1st week of patients' ICU stay. Additional objectives were the estimation of the families' need for support and the estimation of satisfaction regarding the information provided by ICU physicians.

Methods: A total of 108 individuals were participated in the study. Participants were interviewed with the Hamilton Anxiety Rating Scale and filled the Beck Depression Scale II on days 1 and 7 of patients' ICU admission. They also filled a self-reported questionnaire which was created by the investigators, involving decision-making procedures; the satisfaction of the families of the patients' care; and the support of the families by medical and nursing staff.

Results: Anxiety levels were not significantly different among 2-time points, whereas rates of depressive symptoms raised significantly from 38% (day 1) to 58.3% (day 7). In cases of anxiety changes, age, education, closeness of relationship, and APACHE II score were the factors been associated. Changes in depressive symptoms were not associated with any of those factors. Over a week, there were significant differences in relatives' views on participating in the decision-making procedure, and on expressing their opinion and concerns regarding the treatment process. Their attitudes about receiving support by the ICU personnel and even by mental health specialists, such as psychologists also changed.

Conclusions: Over the 1st week of ICU admission, depressive symptoms in patients' relatives were gradually evolving, while anxiety symptoms fluctuated, and they were affected by the severity of the patients' condition. Attitudes toward treatment procedures and the perceived need for support also changed. These findings should be taken into account by the ICU personnel.

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A series of evidence-based interventions beginning with an intensive care unit diary and a patient/family educational pamphlet were implemented to address the long-term consequences of critical illness after discharge from the intensive care unit, bundled as post–intensive care syndrome and post–intensive care syndrome–family.

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Aim: The purpose of this article was to highlight the need to provide support for patients and relatives following critical illness and discharge from hospital and how this can be improved through the establishment of user support groups.

Background: Critical illness predisposes patients to extended physical and psychological ill health with the potential for a reduced quality of life. The authors’ personal experience, patient feedback and current literature suggested that there was a need for further support during their recovery.

Methods: Building on an existing formal follow-up service, Intensive Care Unit (ICU) Support Team for Ex-Patients established a patient-centred forum, where patients and relatives could share experiences with others who had also been through critical illness by holding drop-in sessions. Feedback from those attending these flexible and informal sessions indicates that support was needed, and that patients and families have found benefit in sharing experiences with others who can empathize, having been through critical illness themselves.

Conclusions :Our experience has shown there is a need that can be met simply with minimal investment of time and funding but that addresses a gap in patient support that otherwise goes unmet. Although this was a service development in one local area, it could be adapted to ICU patients and relatives more widely.