Barriers and Enablers to Implementing a High-Dependency Care Model in Pediatric Care: A Preimplementation Study

As the level of acuity of pediatric hospital admissions continues to increase, additional pressure is being placed on hospital resources and the nursing workforce.

Currently, there is no formalized approach to care for high-acuity patients on our pediatric inpatient unit.

We used a qualitative descriptive design, guided by the Theoretical Domains Framework and Capability, Opportunity, Motivation-Behaviour (COM-B) model, to conduct focus groups and interviews with clinicians and administrators to identify potential barriers and enablers to implementing a high-dependency care (HDC) model. An HDC model focuses on the relationship between adequate nursing staff resources and patient acuity to improve patient health outcomes.

Participants identified the need for clear guidelines and supportive physical structures to facilitate HDC implementation. Anticipated benefits included enhanced nursing confidence and family-centered care.

Study findings highlight multilevel factors to consider prior to implementing an HDC model on a pediatric inpatient unit.