Systematic review of family engagement interventions in neonatal, paediatric, and adult ICUs.
Natalie S McAndrew, Teresa Jerofke-Owen, Christine A Fortney and 4 others
PMID 33089659WHAT IT FOUND
Family engagement studies in NICUs reported higher infant weight, shorter stays, and lower parental stress in some studies, but results varied; adult ICU studies mainly showed families found basic care involvement acceptable.
Key findings
01Some NICU studies reported higher infant weight, shorter stay, more alert periods, and lower behavioural stress cues with parent engagement, but other physiologic outcomes did not differ.
02Parental stress did not change consistently: six NICU studies reported lower stress, three found no relationship, and two father-only studies disagreed.
03Adult ICU evidence mainly focused on feasibility; patient impact scores were lower in an intervention group, but delirium and length of stay did not differ.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 19 studies, and they were very different in design, setting, intervention components, and outcomes. Most evidence was from NICUs; there was only one paediatric ICU study and four adult ICU studies, so results may not apply to all ICU patients. Study quality was mostly moderate to low, with only one high-quality study, and blinding was rarely possible. Four included studies were pilot or feasibility studies, so they cannot show whether the interventions worked. Family samples were mostly female and often had limited racial diversity, and most studies were done in Western countries. Intervention fidelity was rarely reported, and it was often unclear how nurses delivered the interventions. The review was limited to English-language papers, and negative or non-significant findings may be missing.
The easy way to misread this
Do not read this review as proof that family engagement improves ICU outcomes. Most evidence came from NICU studies with mixed results, and adult ICU studies mainly tested feasibility, so the review cannot show which parts of an intervention helped patients or families.