Impact of a Smart Phone Application on ICU Family and Provider Satisfaction

Saturday, 26 July 2014: 7:20 AM

Florence Schaefer, MS, RN, ACNS-BC
School of Nursing, Texas Woman's University, League City, TX


The most important factor affecting the overall satisfaction of the family with the ICU is the thoroughness of the information that they receive. Family members and their significant others are frequently called upon to share information and to make decisions pertaining to care, particularly when the loved one is a patient in an Intensive Care Unit (ICU) and are unable to make decisions for themselves.   An increase in anxiety and distress experienced by families has particularly been noted when they receive poor communication.  Communication barriers, fear, and uncertainty all add to the distress levels of family members. 

Literature supports the need to increase and improve communication between healthcare professionals and the patients’ families. There is a need for the family of the critically ill patient to receive updated information more than once to decrease anxiety. It is imperative that these surrogate decision makers are provided with early and effective communication.  The use of print material, as well as computer kiosks as vehicles for better communication are documented in the literature; however there is a paucity of research in which a smart phone application is used to improve and reinforce knowledge and communication with patients’ family members as well as influence family members’ level of satisfaction with information.

The central hypothesis of the proposed study is that the smart phone technology, specifically an application entitled “The ICU Survival Guide”, will improve family satisfaction of ICU patients as measured by the ICU FS-24.  For the study, the application was placed on iPads which were given to the family member for a period of 72 hours or until patient discharge from the ICU.


A randomized control intervention study was conducted to test an application for a smart phone or I Pad as an effective strategy for providing thorough, accurate information to family members of critically ill ICU patients. Three data collection tools were used to evaluate family satisfaction with the care in the Intensive Care Unit, family satisfaction with the application, and staff nurse perception of their interactions with family members of ICU patients who used/ didn’t use the application.

Conducted in three medical-surgical ICUs in a large tertiary hospital in the Texas Medical Center, a sample of 250 study participants was limited to one family member per critically ill patient who was admitted to one of the study units. Participants were randomly assigned to either the intervention or control group.

Study results were analyzed using descriptive and inferential statistics at a level of significance of p = 0.05. The sample size was calculated to reflect a power of 0.80 and a moderate effect.

Results: Data collection is complete and analysis is underway. Results will be reported at the time of the conference.

Conclusions: Family members generally found the “ICU Survival Guide” very informative.  Utilizing an iPad, however, was a barrier to many participants. Participants who were randomly assigned to the intervention group, who either owned iPads or were in the 20-30 age range, were likely to consent participate. Older adults who were assigned to the intervention group, voiced concern and did not want to be responsible for the iPad. They did not want the added stress of learning how to work the iPad and the ICU Survival Guide application.