A Family-Centred Paediatric Delirium Bundle: A Feasibility Study.

Area of Science:

• Pediatric Critical Care Medicine
• Delirium Management
• Family-Centered Care

Background:

• Paediatric delirium (PD) is prevalent in critically ill children, necessitating improved management strategies.
• A family-centered, non-pharmacological delirium management bundle was developed using expert and parent consensus.
• The bundle includes interventions like establishing daily routines and promoting parental presence.

Purpose of the Study:

• To evaluate the feasibility of the PD bundle by assessing its acceptability, implementation, and practicality.
• To gather feedback from parents, nurses, and physicians on the bundle's usability in clinical settings.

Main Methods:

• A mixed-methods process evaluation was conducted, incorporating quantitative surveys and qualitative focus group interviews.
• The study took place in two pediatric cardiac units between March and May 2024.
• Feasibility was assessed against pre-defined goals for acceptability, implementation, and practicality.

Main Results:

• The PD bundle was found acceptable by parents, nurses, and physicians, with all interventions deemed relevant and familiar.
• Six out of eleven interventions were implemented in over 80% of cases, as reported by parents; five interventions fell short of targets.
• Training for delivering the bundle reached 90% of invited nurses and physicians, exceeding the 80% goal. Practical application was challenged by organizational factors and differing hygiene policy interpretations.

Conclusions:

• The developed PD bundle demonstrates potential for acceptance, implementation, and practical use in clinical settings.
• Despite promising initial results, the bundle's delivery fell short of target goals, indicating a need for revision.
• A revised non-pharmacological paediatric delirium bundle should be tested prior to initiating a randomized controlled trial.