Family Engagement and Empowerment

Within the ABCDEF Bundle, the F element refers to Family Engagement and Empowerment. 

The F Element focuses on examining the concept of family presence in the ICU and identifying strategies to create family engagement and empowerment.

Patient-centered care is defined as providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions. Empowering family members with shared decision-making, safety and future care expectations engages them in the patient’s care.

Family and patient-centered care focuses on the following characteristics:

  • Keeping patients and families informed
  • Actively involving patients and families in decision-making
  • Actively involving patients and families in self-management
  • Providing both physical comfort and emotional support to patient and families
  • Maintaining a clear understanding of patients’ concepts of illness and cultural beliefs

Social isolation separates patients from their families. Flexible visitation, including an open ICU, daily meetings with the family, and redesign efforts that target family comfort can all positively impact family presence.

Patient benefits of family presence and flexible visitation (Bell L. American Association of Critical-Care Nurses Practice Alert) include:

  • Decreased anxiety, confusion, and agitation
  • Reduction in cardiovascular complications
  • Decreased ICU lengths of stay
  • Providing feelings of security
  • Increase in patient satisfaction
  • Increase in quality and safety

Implementing the F Element of the ABCDEF Bundle

Search F Element Resources

For additional resources for Patient, Families and Healthcare providers related to Post-Intensive Care Syndromes (PICS) and quality of life after the ICU, visit MyICUCare.org
 
Family response to critical illness: postintensive care syndrome-family
Citation: Crit Care Med. 2012 Feb;40(2):618-24
Population: Adult
Bundle: F Element
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Family presence during cardiopulmonary resuscitation
Citation: N Engl J Med. 2013 Mar 14;368(11):1008-18
Population: Adult
Bundle: F Element
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Family participation in care to the critically ill: opinions of families and staff
Citation: Intensive Care Med. 2003 Sep;29(9):1498-504
Population: Adult
Bundle: F Element
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Doubt and belief in physicians' ability to prognosticate during critical illness: the perspective of surrogate decision makers
Citation: Crit Care Med. 2008 Aug;36(8):2341-7
Population: Adult
Bundle: F Element
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Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment
Citation: Intensive Care Med. 2014 Jul;40(7):981-7
Population: Adult
Bundle: F Element
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Half the family members of intensive care unit patients do not want to share in the decision-making process: a study in 78 French intensive care units
Citation: Crit Care Med. 2004 Sep;32(9):1832-8
Population: Adult
Bundle: F Element
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Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial
Citation: Send to JAMA. 2009 Aug 19;302(7):741-9
Population: Adult
Bundle: F Element
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Evidence-based palliative care in the intensive care unit: a systematic review of interventions
Citation: J Palliat Med. 2014 Feb;17(2):219-35
Population: Adult
Bundle: F Element
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Randomized, controlled trials of interventions to improve communication in intensive care: a systematic review
Citation: Send to Chest. 2011 Mar;139(3):543-554
Population: Adult
Bundle: F Element
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Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial
Citation: JAMA. 2003 Sep 3;290(9):1166-72
Population: Adult
Bundle: F Element
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Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients
Citation: Crit Care Med. 2007 Jun;35(6):1530-5
Population: Adult
Bundle: F Element
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Clinician statements and family satisfaction with family conferences in the intensive care unit
Citation: Crit Care Med. 2006 Jun;34(6):1679-85
Population: Adult
Bundle: F Element
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Empathy and life support decisions in intensive care units
Citation: J Gen Intern Med. 2008 Sep;23(9):1311-7
Population: Adult
Bundle: F Element
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Families with limited English proficiency receive less information and support in interpreted intensive care unit family conferences
Citation: Crit Care Med. 2009 Jan;37(1):89-95
Population: Adult
Bundle: F Element
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Missed opportunities during family conferences about end-of-life care in the intensive care unit
Citation: Am J Respir Crit Care Med. 2005 Apr 15;171(8):844-9
Population: Adult
Bundle: F Element
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A communication strategy and brochure for relatives of patients dying in the ICU
Citation: N Engl J Med. 2007 Feb 1;356(5):469-78
Population: Adult
Bundle: F Element
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Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction
Citation: Crit Care Med. 2004 Jul;32(7):1484-8
Population: Adult
Bundle: F Element
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The impact of advance care planning on end of life care in elderly patients: randomised controlled trial.
Citation: BMJ 2010;340:c1345
Population: Adult
Bundle: F Element
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