El alta a planta del paciente crítico: vivencias de supervivientes de la UCI de un hospital de tercer nivel

Identifier:  TDX:4332

Handle: https://hdl.handle.net/20.500.11797/TDX4332

Authors:  Romero Pastor, Mónica

Abstract:
Introduction: The experience of critical patient discharge to the ward is a topic that has been widely addressed for many years. Nevertheless, there is still a great deal of dissatisfaction on the part of patients and family members concerning how discharge from the intensive care unit (ICU) to the ward takes place. Among the feelings identified associated with the transition from the critical care unit to the ward, uncertainty has been mentioned in the existing literatura on the subject. Hence analysing the experience of the discharge of the critical patient to the ward from the theoretical perspective of Merle Mishel could suggest useful aspects of care to improve the experience of these patients under such circumstances. Objectives: To learn and comprehend the experience of transition from the ICU to the hospital ward, and to this experience, apply Merle Mishel’s theoretical perspective of uncertainty. Design: A qualitative and descriptive study with a phenomenological approach in a third-level hospital in Barcelona. Methodology: Data were collected between February 2017 and May 2018 by means of 20 in- depth interviews. Results: Discharge from the ICU to the hospital ward is a process of transition that each patient experiences differently. Some patients live the experience with great distress and others, with much joy. This work enables extracting three main issues to allow a better understanding of the transfer to the ward: i) The transition from ICU discharge to the hospitalization ward: feelings that emerge from the transition experience; ii) The significance of “being discharged from the ICU”; and iii) Mishel’s approach: uncertainty and sources of structure. Based on the results of this work, interventions to improve critical patient care from admission to the ICU to discharge from hospital are identified and proposed. Conclusion: Nursing care in general, and the management of uncertainty in particular, have been identified as important elements in the experience of critical patient discharge to the ward since, according to the accounts of the informants, they can make this transition a healthier process with less emotional impact.