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Increasing parental participation during rounds in a pediatric cardiac intensive care unit
Angela Blankenship1, Sheilah Harrison1, Sarah Brandt1
1Angela Blankenship is an advanced nurse practitioner, Sheilah Harrison is a quality improvement project specialist, Sarah Brandt is a registered nurse, and Brian Joy and Janet M. Simsic are attending physicians in the cardiothoracic intensive care unit at The Heart Center at Nationwide Children's Hospital, Columbus, Ohio.
Insights
Inviting parents to morning rounds in a pediatric cardiothoracic intensive care unit (CTICU) significantly increased participation. A family participation bundle improved parent invitations, enhancing communication and potentially reducing anxiety.
Area of Science:
- Pediatric critical care medicine
- Healthcare communication
- Patient and family engagement
Background:
- Parental anxiety and communication are key concerns in pediatric intensive care.
- Involving parents in daily rounds can positively impact their experience and understanding.
Purpose of the Study:
- To improve parent participation in morning rounds within a pediatric cardiothoracic intensive care unit (CTICU).
Main Methods:
- A randomized audit of parent invitations to morning CTICU rounds was conducted.
- A "family participation bundle" including staff education and patient-facing materials was implemented.
- Parental feedback was collected through one-on-one conversations.
Main Results:
- Parent invitations increased from 73% to 94% after intervention.
- Primary reasons for non-participation included parental choice, sleep, and language barriers.
Conclusions:
- A family participation bundle effectively increased parent invitations for morning rounds in the CTICU.
- Staff engagement and addressing concerns were crucial for successful implementation.
Background:
Inviting parents of sick children to participate during the rounding process may reduce parents' anxiety and improve communication between the parents and the health care team.
Objectives:
To increase the percentage of available parents invited to participate in morning rounds in a pediatric cardiothoracic intensive care unit (CTICU).
Methods:
Invitations to parents to participate in morning CTICU rounds were randomly audited from June 2012 to April 2014 (mean, 15 audits per month). From June 2012 to February 2013 (before intervention), 73% of parents available during morning rounds received an invitation to participate. From April 2013 to May 2013, the following interventions (family participation bundle) were implemented: (1) staff education, (2)"Invitation to Rounds" handout added to the parent welcome packet with verbal explanation, (3) bedside tool provided for parents to communicate desire to participate in rounds with the team, (4) reminder to invite parents added to nursing rounding sheet. Following interventions, family feedback was obtained by 1-on-1 (physician-parent) open-ended conversation.
Results:
From April 2013 to April 2014, 94% of parents available during morning rounds received an invitation to participate. Reasons for not participating: chose not to participate (63%), sleeping-staff reluctant to wake (25%), not English speaking (7%), breastfeeding (5%).
Conclusion:
Implementation of a family participation bundle was successful in increasing invitations to parents to participate during morning rounds in the CTICU. Engagement of staff and addressing specific staff concerns was instrumental in the project's success.
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