scholarly journals Clinical Nurse Participation at Family Conferences in the Pediatric Intensive Care Unit

2016 ◽  
Vol 25 (6) ◽  
pp. 489-497 ◽  
Author(s):  
Anne C. Watson ◽  
Tessie W. October
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Pediatric Intensive Care Unit ◽  
Emotional Support ◽  
Pediatric Intensive Care ◽  
Clinical Nurse ◽  
Clinical Nurses ◽  
Family Conference ◽  
The Family

Background Clinical nurses attend family conferences in the intensive care unit, but their role during these meetings is not yet fully understood. Objectives To assess perceived and observed contributions of the clinical nurse during family conferences. Methods Prospective cross-sectional survey and review of 40 audio-recorded family conferences conducted in the 44-bed pediatric intensive care unit of an urban pediatric hospital. Results Survey responses from 47 nurses were examined. Most nurses thought it important to attend family conferences, but identified workload as a barrier to attendance. They perceived their roles as gaining firsthand knowledge of the discussion and providing a unique perspective regarding patient care, emotional support, and advocacy. Audio recordings revealed that bedside nurses attended 20 (50%) of 40 family conferences and spoke in 5 (25%) of the 20. Nurses verbally contributed 4.6% to the overall speech at the family conference, mostly providing information on patient care. Conclusions The clinical nurse is often absent or silent during family conferences in the intensive care unit, despite the important roles they want to play in these settings. Strategies to improve both the physical and verbal participation of clinical nurses during the family conference are suggested, especially in the context of previous research demonstrating the need for more attention in family conferences to social-emotional support and patient advocacy.

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

Physicians' Reactions to Training in a Pediatric Intensive Care Unit

PEDIATRICS ◽  
1974 ◽  
Vol 53 (3) ◽  
pp. 375-383
Author(s):  
I. David Todres ◽  
Mary C. Howell ◽  
Daniel C. Shannon
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Emotional Reactions ◽  
Training Period ◽  
Patient Death ◽  
Training Experience ◽  
Optimal Patient Care

Physician trainees working in a pediatric intensive care unit (ICU) were interviewed early in their training experience, at the end of their training, and 1 to 12 months after their training had ended. Pediatricians responded significantly differently from anesthesiologists: they commented more often about their own feelings, and less often about procedural-intellectual-technical matters as contrasted with feelings and relationships. Pediatricians were also more likely than anesthesiologists to mention their own emotional reactions to ill children, their sense that patient death meant physician failure, and their dismay early in the training period about the stressful intensity of the work. Physicians who were parents differed from those who were not parents by commenting more frequently about their work with the parents of patients, and about the necessity for teamwork. Physician trainees interviewed early in the training period were less reflective about the experience, and less likely to comment on feelings and relationships, compared to those interviewed later. Analysis of the sources of satisfaction and discontent with work in the ICU, as stated by the physician trainees, has been useful in efforts to improve the climate of work and learning in the unit, and to provide optimal patient care.

scholarly journals Support group for families with children in a pediatric intensive care unit

2022 ◽  
Vol 75 (2) ◽  
Author(s):  
Erika Sana Moraes ◽  
Camila Cazissi da Silva ◽  
Luciana de Lione Melo ◽  
Ana Márcia Chiaradia Mendes-Castillo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Support Group ◽  
Emotional Support ◽  
Pediatric Intensive Care ◽  
Planning Tool ◽  
Family Coping ◽  
Social And Emotional ◽  
Families With Children

ABSTRACT Objective: To describe the process of creating and implementing a support group for families with children in a pediatric intensive care unit. Methods: A professional experience report described using a management and planning tool. Results: This is a pioneering initiative in the hospital. The application of the tool enabled the delineation of the scope, justification, location, frequency, responsible persons, approach, and budget. After its implementation, the group enables significant interaction between health professionals-families and families-families, favoring the formation of therapeutic bonds and stimulating social and emotional support networks. Conclusion: The tool effectively planned the group and highlighted its effects on family coping and the relationships between professionals and families.

A systematic approach to family engagement: Feasibility pilot of a pediatric delirium management and prevention toolkit

2019 ◽  
Vol 17 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Gabrielle Silver ◽  
Chani Traube
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Improvement Project ◽  
The Family ◽  
Delirium Prevention ◽  
Delirium Management ◽  
Short And Long Term

AbstractObjectiveDelirium is a frequent and severe complication of serious pediatric illness. Development of a nonpharmacologic approach to prevent pediatric delirium may improve short- and long-term outcomes in children and their families. In this brief report, we describe the development of a quality improvement project designed to methodically promote the family member's engagement, comforting, and orienting activities with their critically ill child to decrease delirium rates.MethodWe created a developmentally specific Delirium Prevention Toolkit for families. In a feasibility pilot, March through June 2016, we offered the kit to 15 patients and their families. On discharge, families were asked to describe use of the toolkit and whether or not it was helpful for them.ResultsTwelve of 15 patients and families used various elements of the toolkit, particularly the headphones, music, and games; no one regularly used the blank journal. All reported that it was easy and helpful to have as support for their stay in the pediatric intensive care unit.Significance of resultsThis pilot demonstrated practicality of a nonpharmacologic delirium prevention toolkit in the pediatric intensive care unit, and satisfaction from patients and families.

Pediatric Intensive Care Unit (PICU) Patient Room Design: Identifying Safety Risks in Mirrored Rooms Through a Graphical Systems Analysis

2021 ◽  
pp. 193758672110329
Author(s):  
Anjali Joseph ◽  
Rutali Joshi ◽  
Sahar Mihandoust ◽  
Swati Goel ◽  
Kiran Hebbar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Pediatric Intensive Care Unit ◽  
Systems Approach ◽  
Care Delivery ◽  
Pediatric Intensive Care ◽  
Patient Room ◽  
Design Elements ◽  
Clinical Scenarios

Objective: The objectives of this study are to graphically depict specific clinical challenges encountered in a mirrored pediatric intensive care unit patient room and to represent potential solutions to address these challenges using a systems approach. Background: The intensive care unit (ICU) patient room is a highly complex patient care environment where the design of the room must support patient care delivery safely and efficiently. There is a lack of research examining how ICU design elements interact with other system components to impact patient care. Methods: An observational case study method utilizing a systems approach was used to observe and graphically depict clinical challenges with mirrored room configurations and to identify potential solutions. Video recordings of the three clinical scenarios were analyzed in detail in conjunction with three rounds of interviews with a clinical expert. Results: Equipment or task characteristics that require orienting to a specific side of a patient create challenges in a mirrored room. In order to deliver care safely and efficiently in the mirrored room, adaptations would be required including changing boom, equipment and team member locations, purchasing new equipment, staff training, and inventory management. Some procedures such as extracorporeal membrane oxygenation would be difficult to conduct safely in the mirrored room, even with significant adaptations. Conclusion: Solutions to the challenges presented in mirrored room configurations are multifaceted and require simultaneous and ongoing changes to multiple systems elements, while others can be addressed relatively easily, for example, purchasing new equipment.

Implications of State Scope-of-Practice Regulations for Pediatric Intensive Care Unit Nurse Practitioner Roles

2021 ◽  
Vol 22 (3) ◽  
pp. 221-229
Author(s):  
Kristin H. Gigli ◽  
Grant R. Martsolf
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Pediatric Intensive Care Unit ◽  
Nurse Practitioner ◽  
Pediatric Intensive Care ◽  
Scope Of Practice ◽  
Hospital Level ◽  
Reporting Practices ◽  
Administrative Oversight

Nurse practitioner (NP) advocacy efforts often focus on attaining full practice authority. While the effects of full practice authority in primary care are well described, implications for hospital-based NPs are less clear and may differ because of hospitals’ team-based care and administrative structure. This study examines associations between state scope-of-practice (SSOP) and clinical roles of hospital-based pediatric intensive care unit (PICU) NPs. We conducted a national survey to assess clinical roles of PICU NPs including daily patient care, procedural, and consultation responsibilities as well as hospital-level administrative oversight practices. We classified SSOP as full or limited (reduced or restricted SSOP) practice. We present descriptive statistics and evaluate differences in clinical roles and hospital-level administrative oversight based on SSOP. The final sample included 55 medical directors and 58 lead (senior or supervisory) NPs from 93 of the 140 (66.4%) PICUs with NPs. There were no significant differences in daily patient care, procedural, or consultation responsibilities based on SSOP ( p > .05). However, NPs in full practice authority states were more likely to bill for care than those in limited practice states (66.7% vs. 31.8%, p = .003), while those in limited practice states were more likely to report to advanced practice managers (36.7% vs. 13%, p = .03). For PICU NPs, SSOP was not associated with variation in clinical responsibilities; conversely, there were differences in billing and reporting practices. Future work is needed to understand implications of variation in hospital-level administrative oversight.

Factors Related to Parent Attendance at a Follow-Up Meeting With an Intensivist After a Child’s Death in the Pediatric Intensive Care Unit

2017 ◽  
Vol 79 (4) ◽  
pp. 436-445
Author(s):  
Markita L. Suttle ◽  
Cynthia A. Gerhardt ◽  
Marci Z. Fults
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Pediatric Intensive Care Unit ◽  
Emotional Support ◽  
Pediatric Intensive Care ◽  
Bereaved Parents ◽  
Specific Subset ◽  
Child's Death

Parents who experience the death of a child are at high risk for psychopathology. Because a large percentage of pediatric deaths occur in the pediatric intensive care unit each year, a follow-up meeting between bereaved parents and intensivists could provide essential emotional support, although some parents may not attend. The aim of this study was to explore demographic and medical factors that may distinguish between bereaved parents who attend a follow-up meeting with their child’s pediatric intensivist and those who do not. Our analysis revealed that parents of children who died of trauma were less likely to attend a follow-up meeting with an intensivist. It is possible that symptoms of posttraumatic stress play a role in these findings. Enhanced efforts to identify other interventions for this specific subset of bereaved parents may be necessary.

Communication Patterns During Routine Patient Care in a Pediatric Intensive Care Unit

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Francis F. Ulmer ◽  
Andrea M. Lutz ◽  
Fabienne Müller ◽  
Thomas Riva ◽  
Lukas Bütikofer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Communication Patterns ◽  
Routine Patient Care

scholarly journals Pediatric Intensive Care Unit: reflection in the light of Florence Nightingale’s Environmental Theory

2021 ◽  
Vol 74 (5) ◽  
Author(s):  
Soraya Bactuli Cardoso ◽  
Isabel Cristina dos Santos Oliveira ◽  
Tania Vignuda de Souza ◽  
Sandra Alves do Carmo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Disease Process ◽  
Pediatric Intensive Care ◽  
The Family ◽  
Nursing Team ◽  
History Of ◽  
Environmental Theory ◽  
Final Work

ABSTRACT Objective: To reflect on the environment of the Pediatric Intensive Care Unit in the light of the Florence Nightingale’s Environmental Theory. Methods: A theoretical-reflexive essay of constructs originated from the final work of a discipline related to the Florence Nightingale’s Environmental Theory and the current legislation regarding the environment of the unit. Results: The elements “lighting,” “noise,” “colors, and varieties of objects,” “location of nursing units,” and “odors” follow Florence Nightingale’s assumptions while the elements “ventilation,” “spacing between beds,” “furniture” underwent adaptations to suit the current structure of the unit. Final considerations: The environmental theory is a milestone in the history of nursing. Despite the transformations, such as the emergence of intensive care units and the permanence of the family in these units, the nursing team must maintain Florence Nightingale’s concern about the environment influencing the health/disease process and promoting an adequate environment for the care of the child and his family.

Sign in / Sign up

Export Citation Format

Share Document