Emerging elements of paediatric post-sepsis care programs: A scoping review

Sepsis remains a primary driver of childhood mortality across the Australian continent, disproportionately impacting Aboriginal and Torres Strait Islander populations and those with pre-existing health conditions. Prior research has shown that the transition from intensive hospital environments to domestic settings presents significant physiological and psychological hurdles for young survivors and their caregivers. Existing clinical frameworks often fail to address the enduring sequelae that persist long after the acute infection resolves, leaving many long-term impacts completely unaddressed. Survivors frequently encounter a fragmented healthcare landscape that lacks specialized support for their unique recovery trajectories, which can lead to poor long-term health outcomes. The absence of standardized protocols complicates the long-term management of these vulnerable patients within the community and creates significant stress for families. Families often report feeling abandoned during the post-discharge phase due to a lack of clear guidance and follow-up resources from their primary healthcare providers. This absence of evidence motivated the current investigation into structured support systems for this demographic to improve the overall quality of survivorship care.

This scoping review identifies and characterizes current interventions and organizational models designed for children recovering from septic shock to improve their long-term health outcomes. The investigators sought to synthesize available literature to provide a foundation for a novel post-discharge clinical pathway that addresses the specific needs of paediatric patients. By mapping existing resources, the team aimed to highlight successful components of survivorship programs globally that could be adapted for use in different clinical settings. The analysis focused on extracting actionable elements that could improve the continuity of care for paediatric cohorts during the critical transition from hospital to home. Researchers intended to bridge the gap between acute treatment and long-term wellness through evidence-based program design that incorporates family feedback and clinical expertise. The study targeted the creation of a framework that supports families during the complex reintegration process by providing clear educational resources and support networks. Identifying these elements serves as a critical step toward standardizing paediatric post-sepsis care across diverse healthcare settings to ensure equitable access to recovery services.

The research team utilized the Joanna Briggs Institute (JBI) Scoping Review Framework to structure their systematic search and selection process for relevant paediatric literature. Adherence to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines ensured a high level of transparency and reproducibility in the reporting phase. The Patterns Advances Gaps Evidence for practice and Research (PAGER) structure facilitated the synthesis of findings into meaningful clinical recommendations for healthcare providers and policymakers. Investigators queried multiple electronic databases and the Cochrane Collaboration while also performing targeted searches of grey literature on healthcare and paediatric organization websites. Expert consultations and manual reference list checks supplemented the digital search strategy to capture all relevant paediatric resources that might have been missed. A total of 1843 unique records underwent rigorous screening against predefined inclusion criteria to isolate high-quality evidence regarding existing models of post-sepsis care. The inclusion of grey literature allowed for a broader understanding of current clinical practices that may not yet be published in traditional peer-reviewed scientific journals.

The screening process yielded eight relevant sources, comprising two peer-reviewed articles and six comprehensive grey literature documents that described various aspects of post-sepsis support. Two primary organizational structures emerged: the Children's Hospital of Philadelphia (CHOP) Pediatric Sepsis Survivorship Program and the Queensland Paediatric Sepsis Program (QPSP). The Philadelphia model incorporates a dedicated nurse coordinator who manages discharge education and conducts follow-up assessments at the three-month mark to monitor recovery progress. This program utilizes a specific survivor-needs questionnaire to identify ongoing physical and cognitive challenges in children that may require additional specialized medical intervention. In contrast, the Queensland initiative utilizes a digital ecosystem featuring a family registry, educational videos, and a peer-led mentorship network codesigned with families. Both programs prioritize psychosocial assistance and care coordination, yet neither has undergone formal evaluation to measure clinical outcomes or long-term patient success. Grey literature sources generally described broad service philosophies and general approaches rather than specific, reproducible clinical interventions with defined protocols.

A significant evidence deficit exists regarding structured and rigorously evaluated recovery programs for the paediatric population following a severe septic event. The findings underscore an urgent requirement for comprehensive, family-centred models that account for cultural sensitivities and the unique needs of diverse patient groups. Future research must focus on establishing measurable metrics to validate the efficacy of emerging survivorship interventions and ensure they provide tangible benefits. The identified elements from existing programs have directly informed the design of a new pilot care pathway that will be tested in clinical settings. Implementing these coordinated strategies may mitigate the long-term morbidity associated with severe childhood infections and improve the overall quality of life for survivors. Clinicians should prioritize the integration of psychosocial support into standard discharge protocols for all sepsis survivors to address the mental health impacts of the illness. Establishing a standardized pathway will likely improve the transition from hospital to home for families across Australia and provide a model for international adoption.