Good practices for humanization in pediatric intensive care units: a national Delphi consensus study

Area of Science:

• Pediatric critical care medicine
• Healthcare quality improvement
• Humanization in healthcare

Background:

• Humanization of care is crucial in adult intensive care units.
• Adapting humanization practices for pediatric intensive care units (PICUs) presents unique challenges.
• A validated framework for humanization in PICUs is needed to ensure child- and family-centered care.

Purpose of the Study:

• To adapt and validate a humanization manual for the pediatric intensive care unit (PICU) context.
• To develop a structured and measurable framework for humanization in PICUs.
• To promote child- and family-centered care within pediatric critical care.

Main Methods:

• A methodological study utilizing a three-round Delphi consensus technique.
• 53 experts from 15 Spanish hospitals participated in the consensus process.
• Practices were evaluated, adapted, validated, and classified into three levels (basic, advanced, excellent).

Main Results:

• A total of 132 consensus-validated humanization practices were established for PICUs.
• 47.4% of original practices were adopted without modification, 16.9% were modified, and 35.6% were discarded.
• Practices were categorized as basic (65%), advanced (22%), and excellent (13%).

Conclusions:

• The study successfully adapted and validated the first humanization manual specifically for PICUs.
• The consensus-validated practices provide a structured framework to enhance child- and family-centered care.
• Nursing staff are pivotal in implementing family involvement, communication, and comfort measures, with a tiered classification aiding progressive evaluation.