Abstract
BackgroundHow intensive care teams respond to critical incidents is important for maintaining effective patient care, staff education and morale(1). We investigated Paediatric Intensive Care (PIC) staff experiences of participating in novel 20 minute group ‘time outs’ held after critical incidents.MethodA qualitative study using semi-structured interviews with staff attendees of ‘time outs’. Interviews transcribed and analysed using thematic analysis. Results shared with interviewees for participant validation. Ethical approval granted by the University of Leeds School of Medicine Research Ethics Committee (approval number SOMREC17-020).Results8 semi-structured interviews lasted on average 45 minutes each. Participant roles; 1 Consultant, 1 PIC grid trainee, ST3 Paediatrician, 1 Advanced Nurse Practitioner, 2 Band 6 Nurses and 2 Band 7 Nurses. Thematic analysis generated 1,060 initial codes, subsequently revised until a thematic map emerged, containing five main themes: 1. Context and culture in which critical incidents and ‘time outs’ are embedded, including hierarchy and local politics.2. Pragmatics of organising and evaluating ‘time outs’.3. Position of valued clinical psychologists, who were removed from the ‘time outs’.4. Reflections on coping and resilience, notably blame and fear.5. Process of attending a time out and its impact – both positive (clinical knowledge and the ability to cope) and negative (damaging if inappropriately run).ConclusionThe data contextualised the time outs within the complex PIC environment, with politics, communication challenges and hierarchies affecting how staff respond and how they are supported following critical incidents. Though practical challenges of time outs were noted, this intervention has potential to improve the understanding and well-being of PIC staff after critical incidents.
Attitudes towards fever amongst UK paediatric intensive care staff
