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Post-Intensive Care Syndrome: Educational Interventions for Parents of Hospitalized Children
Stephanie A Esses1, Sara Small2, Ashley Rodemann2
1Stephanie A. Esses is a lead pediatric nurse practitioner in the pediatric intensive care unit, St Louis Children's Hospital, St Louis, Missouri. Ashley Rodemann is a social worker. Sara Small is a social worker and Mary E. Hart-man is an assistant professor, Department of Pediatrics, Washington University in St Louis, St Louis, Missouri. sae9412@bjc.org.
Insights
Targeted education improves caregiver understanding of post-intensive care syndrome (PICS). Brochures, scripted conversations, and videos were effective, with brochures showing the most sustainable implementation potential.
Area of Science:
- Pediatric critical care medicine
- Health education
- Implementation science
Background:
- Post-intensive care syndrome (PICS) affects children and requires caregiver support.
- Caregiver education on PICS signs and symptoms is crucial but optimal strategies are unknown.
Purpose of the Study:
- To evaluate three distinct educational strategies for caregivers of pediatric intensive care unit (PICU) patients.
- To assess the effectiveness, nursing impact, and sustainability of different PICS education methods.
Main Methods:
- A pilot study compared brochures, scripted conversations, and a 3-minute video for PICS education.
- Caregiver understanding and nursing workflow impact were assessed using surveys and Likert scales.
- The Practical, Robust Implementation and Sustainability Model guided the evaluation.
Main Results:
- All three educational strategies significantly improved caregiver PICS knowledge.
- No single strategy proved superior in effectiveness.
- Brochures demonstrated the highest potential for successful and sustainable implementation.
Conclusions:
- Simple, low-cost PICS education is effective and supported by nursing staff.
- Selecting an educational program requires consideration of unit-specific characteristics for sustainability.
Background:
Targeted education to help parents and caregivers recognize the signs and symptoms of post-intensive care syndrome may increase their awareness and willingness to seek support during their child's admission. The optimal strategy for this education has not been established.
Methods:
A pilot study to test 3 educational strategies for caregivers of pediatric intensive care unit patients. The 3 strategies were compared using the Practical, Robust Implementation and Sustainability Model framework for effectiveness of the education, the effect of each educational intervention on the intensive care unit nursing environment, and costs. Nursing responses were scored on a 3-point Likert scale.
Results:
A total of 62 caregivers randomly received 1 of 3 educational strategies: brochures (n = 22), scripted conversation (n = 20), or a 3-minute video (n = 20). All 3 strategies were associated with a notable improvement in understanding of post-intensive care syndrome, with no single strategy being superior. Nineteen bedside nurses completed a survey on how daily workflow was affected and education was perceived. The survey indicated that all 3 interventions minimally disrupted workflow and all were recognized as useful. Final analysis indicated that brochures have the greatest likelihood of successful and sustainable implementation in the study hospital.
Conclusion:
Simple, low-cost education can improve caregivers' knowledge of post-intensive care syndrome and can be well supported by nursing staff. To ensure sustainable implementation, the characteristics of the unit should be considered when selecting an educational program.
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