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Improving mealtimes for paediatric intensive care children and families: A quality improvement initiative
Malorie De Monte1, Emilie M L Marty Petit2, Florent Baudin1
1Paediatric Intensive Care, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France.
Insights
A new room service initiative in paediatric intensive care units (PICUs) successfully involved parents in mealtimes. This improved meal quality and satisfaction for families and healthcare professionals, enhancing overall care.
Area of Science:
- Pediatric Intensive Care
- Nutrition in Critical Care
- Quality Improvement in Healthcare
Background:
- Critically ill children in paediatric intensive care units (PICUs) may have reduced oral intake due to various factors.
- Parental involvement in oral feeding at home is common; active participation during PICU stays may enhance patient and family satisfaction.
Purpose of the Study:
- To evaluate the impact of a "room service" initiative that actively involves parents in pediatric intensive care unit (PICU) mealtimes.
- To assess the effects of this initiative on mealtime quality and satisfaction among families and healthcare professionals (HCPs).
Main Methods:
- A prospective, single-centre, before-and-after study was conducted from 2013 to 2016.
- Surveys were administered to parents of orally feeding children and PICU healthcare professionals (HCPs) to assess oral nutrition practices and satisfaction.
- Statistical analysis included chi-square tests for categorical variables and Mann-Whitney-Wilcoxon tests for Likert scales.
Main Results:
- Post-intervention, significant improvements were noted in overall meal service ratings by both HCPs and families (P < .01).
- Parental involvement, satisfaction of children, families, and HCPs, meal facilities, and the perception of oral nutrition's importance all increased.
- Survey response rates were 75% for HCPs and 52 families pre-intervention, and 57% for HCPs and 54 families post-intervention.
Conclusions:
- Implementing an improved "room service" initiative in the PICU is feasible and enhances perceived quality of care and satisfaction related to oral feeding.
- This family-centered care approach can be effectively integrated into broader quality improvement strategies within the PICU setting.
Background:
Many critically ill children can be fed orally at some point during their paediatric intensive care (PICU) stay, but reduced appetite and other factors may impact their intake. At home, oral feeding is usually delivered by parents, so involving parents more actively during mealtimes in the PICU may contribute to improved patient/family satisfaction.
Aim:
To assess the impact of a new "room service" initiative involving parents on mealtime quality and on both family and health care professional (HCP) satisfaction.
Methods:
A prospective, single-centre, before-and-after intervention study was designed as part of a PICU quality-of-care improvement programme in 2013 to 2016. Two questionnaires assessing oral nutrition practices and family/HCP overall satisfaction were disseminated among the parents of critically ill children capable of oral feeding during their PICU admission and among the whole PICU HCP team (nurses, nurse assistants, and medical doctors). Categorical variables were compared using the chi-square test, and Likert scales were compared between groups with the Mann-Whitney-Wilcoxon test.
Results:
the pre-intervention surveys were completed by 97 of 130 (75%) HCPs and 52 families and the post-intervention surveys by 74 of 130 (57%) HCPs and 54 families. After the intervention, a marked improvement was observed in the overall quality of meal service rating by both HCPs and families (medians and IQR: 5 (5-7) to 7 (7, 8) and 6 (6-8) to 8 (7-9), respectively; P < .01) and also in parents' involvement; in children's, families', and HCP satisfaction; in meal-dedicated facilities and equipment; and in perception that oral nutrition is an important aspect of PICU care.
Conclusions:
Implementation of an improved "room service" initiative in the PICU was feasible and improved the perceived quality of care and satisfaction around oral feeding. This family-centred care initiative can be integrated in an overall quality improvement strategy.
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