Preventing treatment interference: nurses' and parents' intervention strategies

Area of Science:

• Pediatric Critical Care Medicine
• Nursing Research
• Child Psychology

Background:

• Treatment interference, the dislodgement of medical devices, is a common challenge in pediatric intensive care units (PICUs).
• This interference can compromise patient monitoring and treatment efficacy in critically ill children.
• Understanding strategies to maintain the technological interface is crucial for effective pediatric critical care.

Purpose of the Study:

• To explore intervention strategies employed by critical care nurses and parents.
• To identify methods used to maintain the technological interface and prevent treatment interference in young children.
• To understand the perspectives and actions of both caregivers and healthcare providers.

Main Methods:

• An ethological approach was utilized, involving direct observation of 18 children (ages 3-6) in a PICU.
• Data collection included systematic review of health care records and interviews with parents/legal guardians.
• Qualitative content analysis was performed on field notes from observations and interviews.

Main Results:

• Parents implemented psychosocial and physiologic strategies, including manual restraint, to avoid treatment interference.
• Nurses employed a combination of psychosocial, physiologic, activity-based, and environmental strategies.
• Nurses also utilized physical restraint to ensure the stability of the technological interface.

Conclusions:

• Both parents and nurses actively engage in multifaceted strategies to prevent treatment interference in critically ill children.
• A combination of behavioral, environmental, and physical interventions is necessary to maintain critical care technology.
• Further research could explore the effectiveness and long-term implications of these diverse intervention strategies.