Patient and family satisfaction levels in the intensive care unit after elective cardiac surgery: study protocol for a randomised controlled trial of a preoperative patient education intervention

Lai, Veronica Ka Wai; Lee, Anna; Leung, Patricia; Chiu, Chun Hung; Ho, Ka Man; Gomersall, Charles David; Underwood, Malcolm John; Joynt, Gavin Matthew

After obtaining consent, one of the authors will enrol the patients and family members into the trial, and collect the following demographic and clinical data: age, gender, education level, American Society of Anesthesiologists Physical Status Classification, predicted mortality using the logistic European System for Cardiac Operative Risk Evaluation (EuroScore) method, 39 patient's comorbidities, details of surgical procedures, duration of anaesthesia, anaesthetic technique, Richmond Agitation-Sedation Scale score 40 during the ICU stay, delirium assessment Box 1 Information covered in the preoperative video and intensive care unit (ICU) tour ICU environment (video and ICU tour ): â–¸ The standard bedside setting (cardiac monitors, ventilators, pumps, alarms); â–¸ The ICU routine activities-doctor ward rounds, bathing time, etc. Types of invasive tubes and lines for patients after cardiac surgery (video and ICU tour) â–¸ Oral endotracheal tube; â–¸ The pacemaker; â–¸ Chest drainage tubes; â–¸ Urinary catheter; â–¸ Various intravenous lines. Postoperative pain management (video) â–¸ The types of pain experience during the postoperative period; â–¸ The pain relieving method. The medical management (video) â–¸ The common weaning strategy from mechanical ventilator; â–¸ The duration of the placement of the chest drainage tubes; â–¸ What delirium is and how to treat it; â–¸ The expected length of stay in the ICU. Communication between patients, relatives and ICU staff (video and ICU tour) â–¸ Role of case nurse (dedicated bedside nurse); â–¸ Communication methods between the patients, family and nurses; â–¸ Arrangement of the interview between the family, the ICU doctors and/or surgeons. Family support (video) â–¸ The visiting guidelines-number of visitors per visit, visiting hours; â–¸ Demonstration of hand washing when visiting patient; â–¸ The importance of touch to reassure the patient. which will be defined by routine bedside Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), 41 severity of illness score on ICU admission (APACHE II), 42 duration of mechanical ventilation, ICU length of stay, duration of the hospital stay, and the 30-day mortality status from the patient's medical record and from the Hospital Authority Clinical Management System electronic database. If the patient has the educational intervention without a family member, this will be noted in the standardised data collection form and will be included in the analyses. Data will be entered into a passwordprotected MS Access database with built-in data integrity checks (valid values, range and primary key checks) and list of valid descriptive code options.