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

Area of Science:

• Pediatric Nursing
• Healthcare Management
• Patient Acuity

Background:

• Increasing pediatric hospital admission acuity strains resources and nursing staff.
• Lack of a formalized approach for high-acuity pediatric patients exists.
• Pediatric inpatient units face challenges managing rising patient complexity.

Purpose of the Study:

• To identify barriers and enablers for implementing a high-dependency care (HDC) model.
• To explore clinician and administrator perspectives on HDC implementation.
• To address the need for structured care for high-acuity pediatric patients.

Main Methods:

• Qualitative descriptive design utilized.
• Theoretical Domains Framework and COM-B model guided the study.
• Focus groups and interviews conducted with healthcare professionals and administrators.

Main Results:

• Clear guidelines and supportive physical structures are crucial for HDC implementation.
• Participants anticipate improved nursing confidence.
• Enhanced family-centered care is a potential benefit.

Conclusions:

• Multilevel factors must be considered before implementing an HDC model.
• Successful HDC implementation requires addressing identified barriers.
• The study informs strategies for managing high-acuity pediatric patients.