Identification of Dominate Stressors in the Intensive Care Unit (ICU)
Condition: Cardiac Surgery Intensive Care Treatment
Study type: Observational

Summary: 
      Undergoing cardiopulmonary bypass surgery and the subsequent admission to the intensive care
      unit (ICU) is known to be a stressful event to the patient. As patients prepare for
      open-heart surgery it is natural for them to feel anxious and concerned about all the various
      procedures involved in the process. Members of both the surgical and anesthesia team explain
      the purpose of each procedure and all issues associated with the procedures in great detail
      in order to better prepare the patient, ease their anxiety and aid their recovery.

      The underlying assumption for past investigations into overall patient satisfaction has been
      that the stressors inherent in the experience of illness and hospitalization have an adverse
      effect on patient recovery and can possibly prolong the recuperative process. Previous
      studies have shown that the specific performance of a team in regard to the effects of the
      stressors on the patient's status is key to providing optimal patient care in the ICU
      environment. Since the ICU stay is a difficult experience in the life of a patient, stressor
      predictability might allow for better physical and psychological conditions for the patient's
      recovery.

      Although there is a myriad of published research available on the potential stressors related
      to an ICU stay, there is a dearth of investigation into the inherently more intense
      circumstances surrounding a stay in the Cardiothoracic Intensive Care Unit (CT-ICU). By
      examining the stressors in the CT-ICU changes can be made by the medical care team and/or
      hospital that can ultimately enhance the patient experience in the CT-ICU.

      The purpose of this study is to reduce or completely eliminate stressors present in the
      CT-ICU as identified by the cardiac bypass patient. Identification of events and conditions
      considered stressful in the ICU will allow the professional team to determine which stressors
      are amendable to intervention and tailor patient care accordingly.
    

Detailed description: 
      Hypothesis: Identification of events and conditions considered stressful by the
      cardiopulmonary bypass patient would allow the professional team to determine which stressors
      are amendable to intervention and tailor patient care accordingly in order to improve future
      patient care experience in the intensive care unit.

      Research Question: What are the dominant stressors associated with intensive care treatment
      as perceived by the patient, and what measures can be taken by the professional team members
      of the unit to decrease or eliminate these stressors entirely?

      Purpose: The purpose of this study is to reduce or completely eliminate stressors present in
      the CT-ICU as identified by the coronary bypass patient. Identification of events and
      conditions considered stressful in the ICU will allow the professional team to determine
      which stressors are amendable to intervention and tailor patient care accordingly.

      Design: Analytical survey

      Protocol: Patients will be selected based on admission to the ICU following cardiopulmonary
      bypass surgery. We plan to survey 160 patients in order to identify the main stressors in the
      ICU as perceived by the patient themselves. A study investigator will enroll subjects after
      obtaining oral informed consent. We plan to approach eligible candidates once they have been
      discharged from the ICU to the step-down unit (4C). Subjects will be asked to complete a
      short questionnaire that will ask them to assess stressors associated with their stay in the
      CT-ICU. Preliminary analysis will be done to appraise the leading stressors after enrolling
      80 patients in the study. Once dominate stressors have been identified, we will conduct
      several in-services in order to educate the CT-ICU team members of the amendable stressors.
      We will then enroll another 80 patients in order to evaluate whether or not the stressors
      have been reduced and/or eliminated.
    

Observational model: Other
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        This study involves patients both male and female who are admitted to the intensive care
        unit immediately following cardiopulmonary bypass for either myocardial revascularization
        or valvular surgery.
      
Keywords: Stressors; Patient Satisfaction; Cardiothoracic-Intensive Care Unit; Coronary bypass patient