• M A Halm and M A Alpen.
• Critical Care Nursing Division, University of Iowa Hospitals and Clinics, Iowa City.
• Nurs. Clin. North Am. 1993 Jun 1; 28 (2): 443-57.

AbstractThe continuing evolution of the highly specialized, technologic manner in which we provide care in critical care units has potentially hazardous effects on the physical and psychological well-being of patients and family members. Although the ICU environment possesses characteristics that make patients and families prone to undesirable sequelae, critical care nurses can employ creative strategies to minimize the impact of bedside technology that is so important for the survival and recovery of the critically ill patient. Strategies to reduce the psychological impact of the ICU environment begin with a psychosocial assessment of the meaning patients and families attach to bedside technology. This assessment will strengthen nurse, patient, and family interactions, as well as guide patient and family education and sensory information to reduce fear and anxiety often associated with threatening procedures. Facilitating touch and family involvement in the patient's care during visitation is another strategy to humanize the technologic environment. Managing the environment is essential to reduce the physical impact of the ICU environment. Nurses can manipulate the use of equipment to reduce crowding and noise at the bedside, foster familiar activities to stimulate the patient's other senses, and facilitate sleep patterns by structuring nursing activities and providing comfort measures. These nursing interventions will reduce the effects of sensory overload/deprivation and sleep deprivation and, it is hoped, prevent ICU psychosis.

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