Nurse-Led Family Liaison in Adult Intensive Care: From Pandemic Innovation to an Integrated Model for Patient- and Family-Centred Care.

BACKGROUND

Patient- and family-centred care (PFCC) is recognised as a marker of quality in intensive care but remains challenging to operationalise in routine practice. During the COVID-19 pandemic, visiting restrictions prompted the rapid introduction of Family Liaison Services (FLSs) to support communication with families. However, evidence on the feasibility, acceptability, and impact of sustained, nurse-led FLS models in adult Intensive Care Units (ICUs) beyond the pandemic remains limited.

AIM: To evaluate the feasibility, acceptability, and impact of a nurse-led FLS.

STUDY

DESIGN

Single-centre mixed-methods service evaluation conducted in an 18-bed quaternary cardiothoracic adult ICU in London, UK, using responses from a validated family satisfaction survey (FS-ICU 24), a purpose-designed staff feedback survey, and routinely collected service activity records.

RESULTS

Data were analysed from routinely collected service activity records (October 2021-September 2025), family satisfaction survey responses collected pre-implementation (2017) and post-implementation (2022 and 2024), and staff feedback surveys (n = 27 responses; 16% response rate). The nurse-led FLS was delivered by experienced ICU nurses rotating into the role and was later integrated with post-ICU follow-up services. Activity data showed increasing demand, with average monthly contacts rising from 19 in 2022 to 34 in 2025. All staff respondents reported the service to be accessible and beneficial to families. Family satisfaction with the ICU experience increased following FLS implementation, particularly in relation to respect and dignity, emotional support, and communication. Free-text family feedback highlighted dissatisfaction related to delayed communication, while staff described improved understanding of family needs and enhanced coordination of family support.

CONCLUSION

A nurse-led FLS was feasible, acceptable, and associated with improvements in family experience and staff perceptions of family support. Integration with post-ICU follow-up extended continuity of care and facilitated family involvement in service development. Future priorities include sustainable workforce planning, attention to equity in PFCC, and evaluation of longer-term family outcomes.

RELEVANCE TO CLINICAL PRACTICE: A nurse-led FLS offers a replicable model for embedding PFCC within adult intensive care.