Evaluation of patient involvement in patient safety in cardiovascular surgery intensive care units: a qualitative study

BACKGROUND: Patients play a crucial role in healthcare, and their involvement before surgery has been associated with shorter intensive care unit (ICU) stays and faster recovery following cardiac surgery. OBJECTIVES: To explore the experiences and perspectives of patients and nurses regarding patient involvement in the cardiovascular surgery ICU using a qualitative descriptive approach. METHODS: This qualitative descriptive study was conducted in the cardiovascular surgery ICU of a regional hospital between September and November 2024. The study included 12 postoperative patients and 12 nurses selected through purposive sampling. Data were collected through in-depth interviews, semi-structured interviews guided by the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. To ensure rigor and trustworthiness, strategies such as investigator triangulation, peer debriefing, reflexivity, and field notes were used during data collection and analysis. Data were analyzed using Creswell’s five-step thematic analysis framework. RESULTS: The analysis of interviews with patients and nurses revealed five main themes: (1) barriers to patient involvement (2), impact on patient health outcomes (3), impact on nurses (4), practices to enhance patient involvement, and (5) recommendations to improve patient involvement. Patients’ previous passive roles in hospital settings and vulnerability in the ICU hindered their active participation. CONCLUSION: This study revealed that patient involvement in care within the cardiovascular surgery intensive care unit is strengthened by effective communication, trust, collaboration, and nursing support. The findings emphasize the importance of adopting participatory approaches in nursing practice to enhance patient-centered care.