scholarly journals The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention

2016 ◽  
Vol 3 (4) ◽  
pp. 108-118 ◽  
Author(s):  
Kelly N Michelson ◽  
Joel Frader ◽  
Lauren Sorce ◽  
Marla L Clayman ◽  
Stephen D Persell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Stakeholder Engagement ◽  
Pediatric Intensive Care ◽  
Healthcare Team ◽  
Team Members ◽  
Core Elements ◽  
Stakeholder Input

Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

A Descriptive Study of Decision-Making Conversations during Pediatric Intensive Care Unit Family Conferences

2018 ◽  
Vol 21 (9) ◽  
pp. 1290-1299 ◽  
Author(s):  
Michael A. Smith ◽  
Marla L. Clayman ◽  
Joel Frader ◽  
Melanie Arenson ◽  
Natalie Haber-Barker ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Descriptive Study

scholarly journals Parents' Views of Family-Centered Care at a Pediatric Intensive Care Unit—A Qualitative Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Karina Terp ◽  
Janne Weis ◽  
Pia Lundqvist
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Family Centered Care ◽  
Centered Care ◽  
Care And Treatment ◽  
Family Centered ◽  
Parents Experiences

Purpose: To describe parents' views of family-centered care at a pediatric intensive care unit.Design and Methods: A qualitative descriptive study with a deductive and inductive approach was conducted based on the principles of family-centered care. Inclusion criteria were parents of children cared for at a pediatric intensive care unit for at least 48 h. Parents of children who died during the hospital stay were excluded. The sample consisted of spontaneous responses from 70 parents to five open questions in the EMpowerment of PArents in THe Intensive Care questionnaire, which was completed at discharge. The spontaneous responses were analyzed using thematic analysis.Results: The analysis of the parents' statement illuminated that partnership, the essence of family-centered care, appeared incomplete. Partnership was particularly evident regarding parents' experiences of being treated with empathy and respect. It also seemed prominent in situations where the professional team provided support to the child, parents, and family. Based on the parents' statements there was potential for development of the family-centered care approach in aspects such as decision-making concerning care and treatment, as well as improving person-centered communication on order to capture parents' experiences and needs in the highly technological pediatric intensive care unit environment.Conclusions: Although in general parents were satisfied with the care, areas for improvement were identified such as participation in decision-making about care and treatment as well as person-centered communication. The results can contribute to future quality improvement interventions focusing family centered care at pediatric intensive care units.

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.

DECISION MAKING OF THE LATINO PARENT IN THE PEDIATRIC INTENSIVE CARE UNIT.

2007 ◽  
Vol 55 (1) ◽  
pp. S153
Author(s):  
A. Epstein ◽  
T. Morrison ◽  
P. Agbayani ◽  
A. Herrera ◽  
D. Epstein
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care

scholarly journals Empowerment of the mothers of children in a pediatric intensive care unit

2018 ◽  
Vol 71 (3) ◽  
pp. 998-1006 ◽  
Author(s):  
Monique de Sales Norte Azevedo ◽  
Isabel Cristina dos Santos Oliveira ◽  
Tania Vignuda de Souza ◽  
Juliana Rezende Montenegro Medeiros de Moraes ◽  
Elena Araujo Martinez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Qualitative Study ◽  
Information Sharing ◽  
Pediatric Intensive Care Unit ◽  
Teaching Hospital ◽  
Thematic Analysis ◽  
Pediatric Intensive Care ◽  
Essential Support

ABSTRACT Objective: to analyze the process of empowerment of the mothers of children hospitalized in a pediatric intensive care unit (PICU) according to Cheryl H. Gibson’s framework. Method: a qualitative study with a non-directive interview in groups was carried out with 14 mothers in the PICU of a pediatric teaching hospital in the state of Rio de Janeiro, whose data were submitted to thematic analysis. Results: all mothers underwent at least one phase of the process of empowerment. Some of them achieved the phase of participatory competence in the care for their children, being heard by the team and expressing their needs, opinions, and questions. Final considerations: attentive listening and information sharing with mothers is necessary, in order to provide essential support so that they undergo the process of empowerment, thus involving themselves in care and decision-making regarding their children.

Parental decision-making preferences in the pediatric intensive care unit*

2012 ◽  
Vol 40 (10) ◽  
pp. 2876-2882 ◽  
Author(s):  
Vanessa N. Madrigal ◽  
Karen W. Carroll ◽  
Kari R. Hexem ◽  
Jennifer A. Faerber ◽  
Wynne E. Morrison ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Parental Decision ◽  
Parental Decision Making

Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review

2021 ◽  
pp. 107484072097586
Author(s):  
Jesse Wool ◽  
Sharon Y. Irving ◽  
Salimah H. Meghani ◽  
Connie M. Ulrich
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Integrative Review ◽  
Empirical Literature ◽  
Critically Ill Children ◽  
Serious Illness

Parents are commonly responsible for making health care decisions for their seriously ill children in the pediatric intensive care unit (PICU); however, the factors influencing their decisions may vary. This integrative review examined the empirical literature between 2013 and 2018 to understand factors pertaining to parents’ decision-making about serious illness care of their children in the PICU. Seventeen studies met the inclusion criteria with three key findings. First, parent–clinician communication in the PICU is critical; second, most parents want to be the final decision-maker for their critically ill child; and third, parents’ emotions, support systems, and the child’s clinical status impact decision-making. Parental perspectives are important to consider when discussing serious illness care decisions for critically ill children. Further inquiry is needed into how the parent–clinician encounter impacts the decision-making process and subsequent outcomes in this population.

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