Using an intervention mapping approach to develop a discharge protocol for intensive care patients.
Open accessAbstract
BACKGROUND: Admission into an intensive care unit (ICU) may result in long-term physical, cognitive, and emotional consequences for patients and their relatives. The care of the critically ill patient does not end upon ICU discharge; therefore, integrated and ongoing care during and after transition to the follow-up ward is pivotal. This study described the development of an intervention that responds to this need. METHODS: Intervention Mapping (IM), a six-step theory- and evidence-based approach, was used to guide intervention development. The first step, a problem analysis, comprised a literature review, six semi-structured telephone interviews with former ICU-patients and their relatives, and seven qualitative roundtable meetings for all eligible nurses (i.e., 135 specialized and 105 general ward nurses). Performance and change objectives were formulated in step two. In step three, theory-based methods and practical applications were selected and directed at the desired behaviors and the identified barriers. Step four designed a revised discharge protocol taking into account existing interventions. Adoption, implementation and evaluation of the new discharge protocol (IM steps five and six) are in progress and were not included in this study. RESULTS: Four former ICU patients and two relatives underlined the importance of the need for effective discharge information and supportive written material. They also reported a lack of knowledge regarding the consequences of ICU admission. 42 ICU and 19 general ward nurses identified benefits and barriers regarding discharge procedures using three vignettes framed by literature. Some discrepancies were found. For example, ICU nurses were skeptical about the impact of writing a lay summary despite extensive evidence of the known benefits for the patients. ICU nurses anticipated having insufficient skills, not knowing the patient well enough, and fearing legal consequences of their writings. The intervention was designed to target the knowledge, attitudes, self-efficacy, and perceived social influence. Building upon IM steps one to three, a concept discharge protocol was developed that is relevant and feasible within current daily practice. CONCLUSION: Intervention mapping provided a comprehensive framework to improve ICU discharge by guiding the development process of a theory- and empirically-based discharge protocol that is robust and useful in practice.
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There are only a limited number of comparable academic articles using IM in clinical psychology, although IM use is prevalent in health and prevention research.
“Although the use and reporting of IM approaches is prevalent in health and prevention research (34–39), there are only a limited number of comparable academic articles published in the field of (clinical) psychology (40, 41).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [35]
The Methods > Study design passage describes an IM-based ICU discharge study and notes earlier uses in health promotion. It does not address how many comparable IM articles have been published in clinical psychology; searches for clinical psychology and comparable articles found no such discussion in our copy. (LLM, conf=0.76)
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- Authors
- van Mol, M., Nijkamp, M., Markham, C., & Ista, E.
- Affiliations
- Open University of the Netherlands (NL)
- The University of Texas Health Science Center at Houston (US)
- Erasmus MC (NL)
- Venue
- BMC Health Services Research
- Published
- 2017-12
- Volume
- 17
- Issue
- 1
- Pages
- 837-837
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC5737483
- OpenAlex
- W2780948325
- Cited by
- 22
- References
- 78
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- FWCI
- 1.21
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- Language
- en
- Open access
- gold
- doi.org
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- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DSpace (Open University in the Netherlands) (submittedVersion, cc-by)
- DSpace (Open University in the Netherlands) (submittedVersion, other-oa)
- Funders
- Erasmus MC, “Evidence Based Care by Nurses”, (2015-15404)
- Topics
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- intensive care unit discharge, discharge protocol, intervention mapping, critical illness, lay summaries, discharge information, nurses' knowledge and attitudes, barriers to discharge, self-efficacy, relatives of ICU patients
- MeSH terms
- Clinical Protocols, Critical Care, Female, Humans, Intensive Care Units, Interviews as Topic, Male, Patient Discharge, Patients' Rooms, Critical Illness, Program Development, Evidence-Based Practice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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