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Toward the inclusion of parents on pediatric critical care unit rounds
Gladys McPherson1, Rosella Jefferson, Niranjan Kissoon
1University of British Columbia School of Nursing, Vancouver, British Columbia, Canada.
Insights
Parents want to join pediatric intensive care unit (PICU) rounds, but healthcare providers have concerns. Successful parental inclusion requires addressing communication, confidentiality, and time constraints for quality care.
Area of Science:
- Pediatric Intensive Care
- Healthcare Quality Improvement
- Patient-Centered Care
Background:
- Parental inclusion in pediatric intensive care unit (PICU) rounds is recognized as a parental right and a quality care indicator.
- Implementing policies for parental involvement in rounds presents challenges in many healthcare settings.
Purpose of the Study:
- To understand the contexts influencing parental inclusion in PICU rounds.
- To develop a feasible, relevant, and sustainable approach for incorporating parents into patient rounds.
Main Methods:
- A qualitative and descriptive exploratory survey was conducted in a tertiary care children's hospital's PICU.
- Surveys and in-depth interviews were administered to healthcare providers and parents of admitted children.
Main Results:
- Parents expressed a strong desire to participate in PICU rounds.
- Healthcare providers showed varied opinions on the benefits of parental participation.
- Key factors for successful inclusion include communication, confidentiality, time management, and defining roles.
Conclusions:
- Parental participation in PICU rounds is considered important by study participants.
- Effective and sustainable parental inclusion necessitates policy changes recognizing parents as contributors.
- Healthcare providers' responsibilities within the PICU environment must be considered for successful integration.
Background:
Inclusion of parents on interprofessional patient rounds is increasingly recognized as a parental right and as a marker of quality care in pediatric intensive care units. Creating policies and practices that welcome parents and their contributions into patient rounds has proven challenging in many settings.
Objective:
To develop a detailed understanding of the physical, professional and interpersonal contexts of one pediatric intensive care unit in order to develop a feasible, relevant and sustainable approach to parental inclusion on rounds.
Design:
Prospective qualitative and descriptive exploratory survey.
Setting:
A pediatric Intensive care unit at a tertiary care children's hospital.
Subjects:
Physicians, nurses and other health care professionals working in our pediatric intensive care unit and to all parents who had children admitted to the unit during a one month period.
Interventions:
None.
Measurement And Main Results:
Surveys were distributed to physicians, nurses and other health care professionals working in our pediatric intensive care unit and to all parents who had children admitted to the unit during a 1-month period. In addition in-depth interviews were conducted with a subset of 13 healthcare providers. Descriptive statistics were used to report survey results. Transcripts of the interviews and the qualitative comments provided on the surveys were analyzed according to principles of interpretive description. Parents indicated a strong desire to participate in pediatric intensive care unit rounds, while healthcare providers varied in the extent to which they believed parents' participation would achieve the intended goals. Key considerations that need to be addressed for successful practice change to incorporate parents on rounds include: working on consistent and reliable communication, addressing the issues of confidentiality, time constraints, and teaching during rounds, and attention to the role of parents during rounds and health care professionals' facilitation of that role.
Conclusion:
The participants in this study believed that parents' participation on rounds is an important consideration. For inclusion of parents to be effective and sustainable, policy and practice change in this direction requires measures to recognize parents as important contributors to pediatric intensive care unit rounds while accounting for the complex responsibility of healthcare providers in the physical and social space of the pediatric intensive care unit.
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