Clinical ethics support services in paediatric practice: protocol for a mixed studies systematic review on...

Area of Science:

• Medical Ethics
• Pediatric Healthcare Quality
• Systematic Review Methodology

Background:

• Clinical ethics support services (CESS) are increasingly recognized globally.
• Paediatric-specific CESS (p-CESS) have received limited research attention.
• Existing adult CESS evidence may not be generalizable to pediatric populations.

Purpose of the Study:

• To systematically identify, appraise, and synthesize evidence on p-CESS.
• To provide a foundation for quality evaluation and minimum standards for p-CESS.
• To address the gap in knowledge regarding pediatric clinical ethics support.

Main Methods:

• Mixed-studies systematic review of empirical studies in English/Spanish.
• Searched seven databases (MEDLINE, PsycINFO, etc.) using terms related to "clinical ethics support," "paediatrics," and "structure/process/outcome."
• Employed narrative and thematic synthesis guided by Donabedian's framework; quality assessed with MMAS (2018).

Main Results:

• Evidence synthesis on structures, processes, and outcomes of p-CESS is currently limited.
• The review will identify key characteristics and impacts of existing p-CESS models.
• Data on the evaluation and impact of p-CESS will be systematically compiled.

Conclusions:

• Robust evidence on p-CESS structures, processes, and outcomes is needed.
• This review will inform the development of quality indicators and best practices for p-CESS.
• Findings will guide future research and policy for pediatric clinical ethics support.