Nosocomial infections are a cause of concern for hospital patients and the incidence rates of these infections are greater in intensive care units (ICUs) due to the invasive nature of treatments, additional risk factors and comorbidities, and therapies used. Invasive devices, such as vascular central lines, Foley catheters, and mechanical ventilators pose a risk for critically ill patients in the ICUs to develop device-related, healthcare-associated infections (HAI). The purpose of this study was to describe the epidemiological characteristics of patients who developed device-related HAIs within 3 ICU units (medical-surgical, cardiovascular, and neurosurgical) of an academic medical facility. The ecosocial theory of disease distribution provided the theoretical framework for the study to describe how ecological and social determinants interact and affect health variances. Secondary data were analyzed using analysis of variance (ANOVA), Pearson correlations, and chi-square statistical tests. A total of 4,213 patients admitted to the 3 ICUs from 2010-2014 were identified. According to the chi-square analysis, there was significant association between race/ethnicity and type of device-associated infection; between gender and types of infection; and between risk factors (diabetes, obesity, smoking habits) and kinds of infection, all of which the statistical significance had varied for each individual ICU. Bacterial differences were noted between device-associated infections. The potential positive social change from this study could be insight on possible new processes and interventions to reduce nosocomial infections and improve adult ICU patient outcomes such as decreased HAIs, decreased length of stay, comorbidities, and cost for both the patient and the hospital.

The purpose of this qualitative study was to supply preliminary insights into improving the support of visiting families with children who are minors during the intensive care unit stay (ICU) of an adult family member. Hospitals often restrict children from visiting in ICUs; however, a review of the literature revealed that despite the prevalence of this policy, there has been little research into whether visiting is harmful or supportive (Liu et al., 2013; Manici & Ghillani, 2018). Although family-centred care (FCC) is considered beneficial for adult family members (Davidson et al., 2012; Eggenberger & Nelms, 2007), there is little evidence that policymakers have considered the involvement of children during an ICU stay (Knutsson & Bergbom, 2007). In this study, seven families shared their experiences of the critical illness of a loved one. Using a constructionist lens, this study explored the interaction between the gathered stories and the policies and practices associated with child and adult family members visiting adult critical care contexts in British Columbia (BC), Canada. This study found that the involvement of children in a family illness event is important and that tailoring involvement to the individual preferences of the child, and their family, is crucial. While navigating an ICU stay, families may benefit from a collaborative approach between the child, their caregiver/s, and a member of the ICU team. The goal of this research is that it will resonate with its readers and move people to deeper curiosity and further study. This exploratory study led to a list of seven preliminary recommendations that could inform the interdisciplinary policies and practices associated with supporting child and adult family members as visitors in an ICU. Further research is needed to explore the experiences of families with children more fully, and to understand the systems that need to be in place to support them during the critical illness of a loved one. / Graduate / 2021-12-16