The impact of family centred care interventions in a neonatal or paediatric intensive care unit on parents’ satisfaction and length of stay: A systematic review

2019 ◽  
Vol 50 ◽  
pp. 63-70 ◽  
Author(s):  
Elisabeth Segers ◽  
Henrietta Ockhuijsen ◽  
Petra Baarendse ◽  
Irene van Eerden ◽  
Agnes van den Hoogen
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
The Impact

Clinical and Economic Outcomes of Telemedicine Programs in the Intensive Care Unit: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 33 (7) ◽  
pp. 383-393 ◽  
Author(s):  
Jing Chen ◽  
Dalong Sun ◽  
Weiming Yang ◽  
Mingli Liu ◽  
Shufan Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Icu Length Of Stay ◽  
The Impact

Objective: To evaluate the impact of telemedicine programs in intensive care unit (Tele-ICU) on ICU or hospital mortality or ICU or hospital length of stay and to summarize available data on implementation cost of Tele-ICU. Methods: Controlled trails or observational studies assessing outcomes of interest were identified by searching 7 electronic databases from inception to July 2016 and related journals and conference literatures between 2000 and 2016. Two reviewers independently screened searched records, extracted data, and assessed the quality of included studies. Random-effect models were applied to meta-analyses and sensitivity analysis. Results: Nineteen of 1035 records fulfilled the inclusion criteria. The pooled effects demonstrated that Tele-ICU programs were associated with reductions in ICU mortality (15 studies; risk ratio [RR], 0.83; 95% confidence interval [CI], 0.72 to 0.96; P = .01), hospital mortality (13 studies; RR, 0.74; 95% CIs, 0.58 to 0.96; P = .02), and ICU length of stay (9 studies; mean difference [MD], −0.63; 95% CI, −0.28 to 0.17; P = .007). However, there is no significant association between the reduction in hospital length of stay and Tele-ICU programs. Summary data concerning costs suggested approximately US$50 000 to US$100 000 per Tele-ICU bed was required to implement Tele-ICU programs for the first year. Hospital costs of US$2600 reduction to US$5600 increase per patient were estimated using Tele-ICU programs. Conclusions: This systematic review and meta-analysis provided limited evidence that Tele-ICU approaches may reduce the ICU and hospital mortality, shorten the ICU length of stay, but have no significant effect in hospital length of stay. Implementation of Tele-ICU programs substantially costs and its long-term cost-effectiveness is still unclear.

Trends in long-stay admissions to a UK paediatric intensive care unit

2019 ◽  
Vol 105 (6) ◽  
pp. 558-562 ◽  
Author(s):  
Hari Krishnan Kanthimathinathan ◽  
Adrian Plunkett ◽  
Barnaby R Scholefield ◽  
Gale A Pearson ◽  
Kevin P Morris
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Paediatric Intensive Care Unit ◽  
Hospital Admissions ◽  
Paediatric Intensive Care ◽  
Hospital Length Of Stay ◽  
Resource Utilisation ◽  
High Resource ◽  
Bed Days

ObjectiveProlonged admission to a paediatric intensive care unit (PICU) consumes significant healthcare resource. An increase in the number of long-stay admissions and bed utilisation has been reported elsewhere in the world but not in the UK. If an increasing trend of long-stay admissions is evident, this may have significant implications for provision of paediatric intensive care in the future.Design/setting/patientsWe retrospectively analysed prospectively collected data from Birmingham Children’s Hospital, UK, over a 20-year period from 1998 to 2017. PICU admissions, bed-days, length of stay and mortality trends were analysed and reported over four different epochs (1998–2002, 2003–2007, 2008–2012 and 2013–2017) for long-stay admissions (PICU length of stay ≥28 days) and others. Differences in patient demographics, diagnostic categorisation and hospital utilisation were also analysed.ResultsIn total, 24 203 admissions accounted for 131 553 bed-days over the 20-year period. 705 (2.9%) long-stay admissions accounted for 42 312 (32%) bed-days. Proportion of long-stay admissions and corresponding bed-days increased from 1.6% and 20.5% in 1998–2002 to 4.5% and 42.6%, respectively, in 2013–2017 (p<0.001). Long-stay patients had a significantly higher number of hospital admissions (median: 4 vs 2, p<0.001) per patient and overall hospital length of stay (median: 98 vs 15, p<0.001) bed-days compared with other patients. Long-stay admissions were associated with significantly higher crude mortality (23% vs 6%, p<0.001) compared with other admissions.ConclusionsA significant increase in the proportion of prolonged PICU admissions with disproportionately high resource utilisation and mortality is evident over two decades.

The impact of transfers from neonatal intensive care to paediatric intensive care

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emma E. Williams ◽  
Rebecca Lee ◽  
Nia Williams ◽  
Akash Deep ◽  
Nadisha Subramaniam ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Neonatal Intensive Care ◽  
Cost Of Care ◽  
Paediatric Intensive Care ◽  
Bed Capacity ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Objectives Infants receiving care from neonatal intensive care unit (NICU) can develop chronic problems and be transferred to a paediatric intensive care unit (PICU) for on-going care. There is concern that such infants may take up a large amount of PICU resource, but this is not evidence based. We determined the impact of such transfers. Methods We reviewed 10 years of NICU admissions to two tertiary PICUs, which had approximately 12,000 admissions during that period. Results Sixty-seven infants, gestational age at birth 34.7 (IQR 27.1–38.8) weeks and postnatal age on transfer 81 (IQR 9–144) days were admitted from NICUs. The median (IQR) length of stay was 12 (4–41) days. The 19 infants born <28 weeks of gestation had a greater median length of stay (32, range IQR 10–93 days) than more mature born infants (7.5, IQR 4–26 days) (p=0.003). The median cost of PICU stay for NICU transfers was £23,800 (range 1,205–1,034,000) per baby. The total cost of care for infants transferred from NICUs was £6,457,955. Conclusions Infants transferred from NICUs were a small proportion of PICU admissions but, particularly those born <28 weeks of gestation, had prolonged stays which needs to be considered when determining bed capacity.

Parental perceptions of the impact of COVID-19 restrictions on family-centred care at a paediatric intensive care unit

2021 ◽  
Vol 2 (4) ◽  
pp. 195-200
Author(s):  
Kieran Bannerman ◽  
Lorna Aitken ◽  
Peter Donnelly ◽  
Christopher Kidson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Paediatric Intensive Care Unit ◽  
Parental Perceptions ◽  
Paediatric Intensive Care ◽  
Additional Stress ◽  
Free Text ◽  
The Impact ◽  
Paediatric Intensive Care Units

Background/Aims Restrictions to clinical practice necessitated by the COVID-19 global pandemic exerted pressures on staff, families and patients within the paediatric intensive care unit of the Royal Hospital for Children in Glasgow. The authors sought to explore parents' experiences during this pandemic. Methods A single centre study was performed using a questionnaire distributed to parents of patients in the 22-bed paediatric intensive care unit. The key areas targeted were visiting restrictions, ward round changes, facilities closures and the need to wear personal protective equipment. Free text responses were reviewed by two authors independently and common themes identified. Results The findings offer insight into family perceptions that illustrate the negative repercussions of the restrictions to parents. Understanding on the part of the parents was demonstrated throughout; however, restrictions and pandemic interventions also resulted in isolation, distress, exclusion and anxiety. Conclusions There are no current studies exploring parental perceptions of COVID-19 interventions within paediatric intensive care units. These findings offer insights that illustrate the unique challenges faced by those who strive to deliver family-centred care, and the additional stress that this can put upon parents. The authors propose adaptive strategies to enhance family-centred care at paediatric intensive care units.

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