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Every child, every day, back to play: the PICUstars protocol - implementation of a nurse-led PICU liberation program

M Waak1,2, J Harnischfeger3, A Ferguson3

  • 1Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, Queensland, 4101, Australia. Michaela.Waak@gmail.com.

BMC Pediatrics
|May 13, 2022
PubMed

Insights

This study investigates the ICU Liberation bundle for pediatric intensive care units (PICU) to improve patient recovery and reduce complications. The goal is to create guidelines for adapting and implementing this evidence-based model in other pediatric hospitals.

Area of Science:

  • Pediatric critical care medicine
  • Implementation science
  • Quality improvement in healthcare

Background:

  • Rising pediatric intensive care unit (PICU) admissions and declining mortality shift focus to survivorship quality.
  • Lack of international guidelines for managing PICU complications (e.g., over-sedation, delirium, immobility) impacts recovery and increases costs.
  • The ICU Liberation bundle (ABCDEF) shows promise in adults but needs evaluation in pediatric settings.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of the nurse-led ICU Liberation model in a mixed quaternary PICU.
  • To adapt and implement the ICU Liberation bundle for pediatric critical care.
  • To minimize PICU-related problems and improve long-term functional outcomes for pediatric patients.

Main Methods:

  • A single-center, before-and-after implementation study (PICU-STARS).
  • Prospective baseline assessment of current PICU practices to inform bundle adaptation.
  • Mixed-methods approach using the Consolidated Framework for Implementation Research (CIFR) to assess feasibility, implementation outcomes, and intervention effectiveness.
  • Formative feedback through focus groups, interviews, questionnaires, and observations to analyze barriers and enablers.

Main Results:

  • The study is currently recruiting, and results are pending.
  • Data collection will inform the fine-tuning of the Liberation bundle adaptation and implementation process.
  • Outcomes will be reported using standard descriptive statistics and analytical techniques, accounting for patient severity.

Conclusions:

  • The study aims to produce a detailed guideline for adapting and implementing the ICU Liberation bundle in pediatric hospitals.
  • This guideline will include necessary clinical resources and investment information.
  • Findings will support the adoption of PICU-STARS in other children's hospitals to improve care quality.
Abstract

Keywords:
ABCDEF bundleChildCritical carePaediatricPost intensive care syndrome

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