Review
Patients’ transition in the Intensive Care Units: Concept analysis

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Summary

Background

Adequate preparation of critically ill patients throughout their transition experience within and following discharge from the Intensive Care Unit is an important element of the nursing care process during critical illness. However, little is known about nurses’ perspectives of, and engagement in, caring for critically ill patients during their transition experiences.

Aim

This paper aims to review the literature about the concept of transition within the context of critically ill patients in the Intensive Care Unit, focusing on Intensive Care Unit nurses.

Review method

CINAHL, MEDLINE, OVID, Science Direct, SAGE eReference and SAGE Journal Online data bases were searched for relevant literature published since 1970.

Results

The critically ill patients’ transitions in Intensive Care Units are generally described as a period of transfer or change of situation, or the experience of inner change or role during and after the illness. The critically ill patients’ transition experience per se is not directly described, nor is nurses’ understanding of it.

Conclusion

Nurses’ understanding of critically ill patients’ transition may significantly impact the patients’ care in the Intensive Care Unit. Thus, research is needed that focuses more on evaluating nurses’ understanding of patients’ transition and its consequences.

Introduction

Transition is a concept that can be described as a process and an outcome. The concept offers a key to interpreting person–illness–environment interactions in terms of their actual and potential effects on health (Chick and Meleis, 1986). Thus, careful conceptualisation of transition and its bio-psychosocial-cultural consequences may assist in providing therapeutic nursing to critically ill patients. Such patients generally require a package of care to support their complex needs while they regain good health (Foust, 2007). Improved management of patients in the acute phase of a critical illness may increase their chances of survival but does not guarantee a return to full health (Hutchison, 2007). Hence, appropriate preparation of patients throughout their health and illness transitions is a vital aspect of recovering from critical illness.

Section snippets

Aim and review method

This paper aims to review the concept of transition within the context of critically ill patients, focusing on Intensive Care Unit nurses.

Various combinations of the terms transition, transition experience, transitional care, transfer, critically ill patients and ICU nurses’ perception were entered into CINAHL, MEDLINE, OVID, Science Direct, SAGE eReference and SAGE Journal Online data bases. The key search combination was ‘transition and ICU patients’ transition and critically ill patients and

Defining the concept of transition

The term ‘transition’ is derived from the Latin verb ‘transire’, meaning to go across (Chick and Meleis, 1986). The original meaning is reflected in today's meaning: a ‘passage from one state, stage, subject, or a change of place to another or a movement, development, or evolution from one form, stage, or style to another’ (Macquarie English Dictionary, 2006, p. 1303).

In nursing terms, transition can be defined as follows

Transition can be said to occur if an event or non-event results in a change in assumptions about oneself and the world and thus

Conclusion

The literature about transition implies that nurses need an improved understanding of critically ill patients’ transition experiences in the Intensive Care Unit to assist them in their therapeutic interventions for these patients. This is important because patients’ transitions impact on the patient, family and health professionals involved in the patients’ care. The lack of literature specific to nurses’ understanding of patients’ transition during their Intensive Care Unit stay is concerning.

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