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Developing rights-based standards for children having tests, treatments, examinations and interventions: using a
Lucy Bray1, Bernie Carter2, Joann Kiernan3
1Edge Hill University, Ormskirk, UK. Brayl@edgehill.ac.uk.
Insights
New international standards address harm to children during clinical procedures. These rights-based guidelines, developed through multi-stakeholder consensus, offer tools to improve child-centered care and challenge assumptions about holding or restraining children.
Area of Science:
- Pediatric healthcare
- Clinical procedure best practices
- Child rights in medicine
Background:
- Children experience harm during clinical procedures despite evidence for child-centered care.
- Healthcare professionals face challenges applying evidence-based practices to pediatric procedural care.
- Existing guidelines lack international consensus on supportive and restraining holds for children.
Purpose of the Study:
- To develop international, rights-based standards for pediatric procedural care.
- To establish consensus on definitions and practices for supportive and restraining holds.
- To provide evidence-based tools for improving child-centered care during clinical procedures.
Main Methods:
- Iterative, multi-phased, multi-method, and multi-stakeholder consensus-building approach.
- Engagement with 203 children, 78 parents, and 418 multi-disciplinary professionals over two years (2020-2022).
- Utilized online and face-to-face methods to ensure broad stakeholder input.
Main Results:
- Developed the first international, rights-based procedural care standards from multi-stakeholder perspectives.
- Achieved international consensus on definitions for supportive and restraining holds for children.
- Gathered comprehensive data from diverse stakeholders on children's procedural care needs.
Conclusions:
- The developed standards represent a significant advancement in international pediatric procedural care.
- These standards provide actionable tools for healthcare professionals to enhance child-centered practices.
- The findings encourage a shift towards prioritizing children's interests and rights, challenging traditional approaches to holding and restraint.
Abstract:
Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020-2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds. Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child. What is Known: • Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. • Professionals report uncertainty and tensions in applying evidence-based practice to children's procedural care. What is New: • This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives. • The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.
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