Nurse-led family participatory support intervention on clinical outcomes in ICU patients: a prospective quasi-experimental study.

BACKGROUND

Delirium is a common and serious complication in critically ill patients, and family-centered care has emerged as a promising non-pharmacological strategy. However, evidence on structured, nurse-led family participatory support (NFPS) intervention remains limited.

AIM: To evaluate the effectiveness and safety of NFPS in critically ill adult patients.

METHODS

Adult patients admitted to intensive care units (ICU) from three tertiary hospitals in Gansu Province were allocated to either the NFPS group or a usual care group without family participation (non-NFPS). In the NFPS group, trained family members participated in care under the guidance of ICU nurses. The primary outcome was the incidence of delirium.

RESULTS

After 1:1 propensity score matching, 365 patients were included in each group. The NFPS group demonstrated significant reductions in incidence of delirium [26.85% vs. 34.25%, p = 0.03]. Compared with the control group, the NFPS group also had significantly shorter hospital length of stay (HLOS) (25 [17-34] vs. 30 [22-38] days, P < 0.001), ICU-LOS (13 [7-17] vs. 14 [10-18] days, P < 0.001), duration of mechanical ventilation (10 [6-15] vs. 11 [8-17] days, P < 0.001) and lower hospitalization cost (193,931.99 [117,616.64-294,201.02] vs. 199,330.72 [138,636.05-300,993.88] CNY, P = 0.032). No significant differences were observed in 6-month mortality (6.03% vs. 7.67%, P = 0.380), 1-year mortality (9.32% vs. 11.51%, P = 0.330), ICU-acquired weakness (26.58% vs. 29.59%, P = 0.270), ICU-acquired infection (19.45% vs. 19.73%, P = 0.930), or adverse events (2.19% vs. 3.84%, P = 0.190).

CONCLUSION

The NFPS significantly reduced the incidence of delirium and was associated with shorter durations of mechanical ventilation, ICU-LOS, HLOS, lower hospitalization costs, without increasing the risks of ICU-AW, ICU-acquired infection, or adverse events. No significant differences were observed in long-term mortality between the two groups.