Family Participation during Intensive Care Unit Rounds: Goals and Expectations of Parents and Health Care Providers in a Tertiary Pediatric Intensive Care Unit

2014 ◽  
Vol 165 (6) ◽  
pp. 1245-1251.e1 ◽  
Author(s):  
Carolyn A. Stickney ◽  
Sonja I. Ziniel ◽  
Molly S. Brett ◽  
Robert D. Truog
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Health Care Providers ◽  
Pediatric Intensive Care ◽  
Family Participation ◽  
Care Providers

Visitation in the Pediatric Intensive Care Unit: Controversy and Compromise

1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Nancy E. Page ◽  
Nancy M. Boeing
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Health Care Providers ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
The Family ◽  
Centered Care ◽  
Family Centered

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission

scholarly journals Perspectives of Pediatric Providers on Patients With Complex Chronic Conditions: A Mixed-Methods Sequential Explanatory Study

2020 ◽  
Vol 40 (5) ◽  
pp. e10-e17
Author(s):  
Taylor A. Kobussen ◽  
Gregory Hansen ◽  
Rebecca J. Brockman ◽  
Tanya R. Holt
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Health Care Providers ◽  
Chronic Conditions ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
Complex Chronic Conditions ◽  
Semistructured Interviews

Background Children with complex chronic conditions present unique challenges to the pediatric intensive care unit, including prolonged length of stay, complex medical regimens, and complicated family dynamics. Objectives To examine perspectives of pediatric intensive care unit health care providers regarding pediatric patients with complex chronic conditions, and to explore potential opportunities to improve these patients’ care. Methods A prospective mixed-methods sequential explanatory study was conducted in a tertiary medical-surgical pediatric intensive care unit using surveys performed with REDCap (Research Electronic Data Capture) followed by semistructured interviews. Results The survey response rate was 70.6% (77 of 109). Perspectives of health care providers did not vary with duration of work experience. Ten semistructured interviews were conducted. Eight overarching themes emerged from the interviews: (1) the desire for increased formal education specific to pediatric complex chronic care patients; (2) designation of a primary intensivist; (3) modifying delivery of care to include a discrete location for care provision; (4) establishing daily, short-term, and long-term goals; (5) monitoring and documenting care milestones; (6) strengthening patient and family communications with the health care team; (7) optimizing discharge coordination and planning; and (8) integrating families into care responsibilities. Conclusions Pediatric intensive care unit health care providers’ perspectives of pediatric patients with complex chronic conditions indicated opportunities to refine the care provided by establishing daily goals, coordinating discharge planning, and creating occasions for close communication between patients, families, and providers.

Navigator-Based Intervention to Support Communication in the Pediatric Intensive Care Unit: A Pilot Study

2020 ◽  
Vol 29 (4) ◽  
pp. 271-282
Author(s):  
Kelly N. Michelson ◽  
Elizabeth Charleston ◽  
Danica Y. Aniciete ◽  
Lauren R. Sorce ◽  
Patricia Fragen ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Health Care Team ◽  
Care Team ◽  
Care Needs ◽  
Family Meetings ◽  
Family Perceptions

Background Communication in the pediatric intensive care unit (PICU) between families and the health care team affects the family experience, caregiver psychological morbidity, and patient outcomes. Objective To test the feasibility of studying and implementing a PICU communication intervention called PICU Supports, and to assess families’ and health care teams’ perceptions of the intervention. Methods This study involved patients requiring more than 24 hours of PICU care. An interventionist trained in PICU-focused health care navigation, a “navigator,” met with parents and the health care team to discuss communication, decision-making, emotional, informational, and discharge or end-of-life care needs; offered weekly family meetings; and checked in with parents after PICU discharge. The feasibility of implementing the intervention was assessed by tracking navigator activities. Health care team and family perceptions were assessed using surveys, interviews, and focus groups. Results Of 53 families approached about the study, 35 (66%) agreed to participate. The navigator met with parents on 71% and the health care team on 85% of possible weekdays, and completed 86% of the postdischarge check-ins. Family meetings were offered to 95% of eligible patients. The intervention was rated as helpful by 97% of parents, and comments during interviews were positive. Conclusions The PICU Supports intervention is feasible to implement and study and is viewed favorably by parents.

Mothers’ Stories about Their Experiences in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Family Factors ◽  
Parental Role ◽  
Parental Distress ◽  
Care Providers

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

scholarly journals Patient- and Family-Centered Video Rounds in the Pediatric Intensive Care Unit

2020 ◽  
Author(s):  
Ryan L. DeSanti ◽  
Diane H. Brown ◽  
Sushant Srinivasan ◽  
Tom Brazelton ◽  
Michael Wilhelm
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Successful Implementation ◽  
Care Providers ◽  
Team Members ◽  
Social Distancing ◽  
Work From Home ◽  
Family Centered

Objective: Management of the coronavirus disease 2019 (COVID-19) pandemic has required social distancing requirements and personal protective equipment shortages, which have forced hospitals to modify patient care rounds. We describe our process developing telemedicine rounds to maintain synchronous, multidisciplinary, pediatric intensive care unit rounds. By adapting available resources using rapid process improvement (PI), we were able to develop patient- and family-centered video rounds (PFCVR). Design: When rounding team members were forced to work from home, we adapted an existing telemedicine platform (VidyoConnect) to perform PFCVR. A quality improvement (QI) team developed an initial standard process, which underwent rapid PI using a small multidisciplinary team. Setting: A 21-bed, mixed medical/surgical/cardiac pediatric intensive care unit. Participants: Critical care patients, families, physicians, consultants, nurses, and ancillary staff. Interventions: The QI team initially met daily, then weekly, sought feedback from nurses, families, and other care providers, and utilized small tests of change to improve the rounding process. Results: We established standardized, socially distanced rounds using VidyoConnect to allow synchronous, multidisciplinary PFCVR. Implementation of a schedule and rounding script facilitated efficient and effective team communication, optimized participation by the entire team, and decreased interruptions. Conclusions: The COVID-19 pandemic compromised the feasibility of the previous rounding process. PFCVR is a safe and effective tool to facilitate communication while adhering to social distancing guidelines. Use of available platforms and team-based PI is critical for successful implementation.

The State of the Do-Not-Resuscitate Order in a Pediatric Intensive Care Unit in the Middle East: A Retrospective Study

2022 ◽  
pp. 082585972110732
Author(s):  
R. Sabouneh ◽  
Z. Lakissian ◽  
N. Hilal ◽  
R. Sharara-Chami
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Middle East ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Patients ◽  
Multiorgan Failure ◽  
Pediatric Intensive Care ◽  
Operative Management ◽  
Care Providers ◽  
Do Not Resuscitate

Objectives The Do-Not-Resuscitate (DNR) order is part of most hospitals’ policies on the process of making and communicating decisions about a patient's resuscitation status. Yet it has not become a part of our society's ritual of dying in the Middle East especially among children. Given the diversity of pediatric patients, the DNR order continues to represent a challenge to all parties involved in the care of children including the medical team and the family. Methods This was a retrospective review of the medical charts of patients who had died in the pediatric intensive care unit (PICU) of a tertiary academic institution in Beirut, Lebanon within the period of January 2012 and December 2017. Results Eighty-two charts were extracted, 79 were included in the analysis. Three were excluded as one patient had died in the Emergency Department (ED) and 2 charts were incomplete. Most patients were male, Lebanese, and from Muslim families. These patients clinically presented with primary cardiac and oncological diseases or were admitted from the ED with respiratory distress or from the operating room for post-operative management. The primary cause of death was multiorgan failure and cardiac arrest. Only 34% of families had agreed to a DNR order prior to death and 10% suggested “soft” resuscitation. Most discussions were held in the presence of the parents, the PICU team and the patient's primary physician. Conclusions The DNR order presents one of the most difficult challenges for all care providers involved, especially within a culturally conservative setting such as Lebanon. As the numbers suggest, it is difficult for parents to reach the decision to completely withhold resuscitative measures for pediatric patients, instead opting for “soft” resuscitations like administering epinephrine without chest compressions.

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