McGill University, Canada
Mélanie Bérubé is an advanced practice nurse in orthopedics and trauma since 2011 at the Hospital du Sacré-Coeur, Montreal, Canada; a large level-one trauma center. She has been a clinical nurse specialist in trauma and critical care fields for 10 years before occupying this position. She completed a post-masters acute care nurse practitioner diploma at the University of Toronto in 2009 and she is currently pursuing Doctoral studies at the Ingram School of Nursing - McGill University, in Montreal. Her research interests are to develop and evaluate nursing interventions in acute care settings for the prevention of adverse events and optimization of patients’ recovery, and knowledge translation.
Background: ICU transfer towards a general ward is recognized as a high-risk episode of care especially for patients with SCI. Objective: To evaluate the feasibility and acceptability of a nursing intervention program developed to optimize the transition of SCI patients and their family from ICU to a trauma unit. Methods: A participative constructivism design was used for the co-construction and preliminary evaluation of interventions by researchers, patients, families and healthcare professionals. Results: Nine tetraplegic patients, 8families and 8 health professionals participated to the study. Interventions pertaining to provision of information with regard to the functioning of the trauma unit and gradual decrease of ICU monitoring and nursing surveillance were found feasible. Other interventions, such as patients and families introduction to the receiving team and the use of a written report form were more difficult to apply. Patients and families considered the program highly acceptable and both greatly appreciated being informed on differences in the intensity of care between the two units. Healthcare professionals also identified the provision of such information as facilitating for the transition of care. Potential improvements identified were visits standardization to the receiving team before ICU discharge, introduction of bedside report to tackle the lack of continuity of care, and education to the nursing personnel of the trauma unit on specific care required by recently ICU transferred SCI patients. Conclusion: The nursing intervention program proposed in this study was found for the most part feasible and acceptable. Need for refinements were identified which will be considered before further evaluation.