The impact of interventions that promote family involvement in care on adult acute-care wards: an integrative review

Background: Healthcare that involves patients and their families in care has been recommended toimprove patient safety and quality. With limited direction on care partnerships for adult acute carepatients, their families and healthcare teams, there is a need for a review of interventions that have beenused to promote family in patient care within adult acute care wards. Aim: The aim of this integrative review was to describe interventions that have been used to promotefamily involvement in patient care within adult acute care wards. Method: Electronic databases of Cumulative Index of Nursing and Allied Health Literature (CINAHL),Cochrane, PubMed, and PsycINFO were searched between 1994 and 2016 using key search terms andword variations ‘family involvement’, ‘family nursing’, family centred care’, family interventions’, ‘familytherapies’. Additional literature was sourced from reference lists of relevant original publications. TheMixed Methods Appraisal Tool and Template for Intervention Description and Replication informed studyand intervention assessment. Findings: Eleven single centered studies were included with interventions designed to improve functionalcapacity, cognitive function, and communication. Nurses were involved in intervention delivery for six of the 11 interventions. Outcomes of interest included patient outcomes (n = 8) and intervention accept-ability and feasibility (n = 3). Improved patient outcomes were reported for seven studies. Interventiondesign and implementation were generally poorly described. Conclusion: Interventions designed to promote family in patient care on adult acute care wards improvedpatient outcomes in some instances, however, methodological limitations confound the evidence base forfamily involvement having a direct and positive impact on patient outcomes. Allowing patients and familymembers to partner in intervention design may enhance uptake and improve outcomes. Process andeconomic evaluations should also be included in future studies to allow assessment of clinical feasibility