Experience-based co-design of paediatric burn service guidance to support parent-administered home dressing changes

Annually over 30,000 children require outpatient treatment for burn accidents. Attending clinic appointments has a negative psychological and social impact on families. Many burns centres offer families the option to administer dressing changes at home without standardised supporting guidance. Families administering dressing changes at home reported a lack of support. This study developed service guidance to support parent-administered paediatric home dressing changes.

Experience-based co-design of service guidance and resources was conducted to address the priorities of service users. Data were collected through clinic observations and interviews with practitioners and parents at three paediatric burns services. Findings were shared with practitioners and parents at co-design events to facilitate agreement on the priorities for service improvements. Two working groups were formed to co-design outputs. The service guidance and resources were piloted across the three sites. Clinic observations and interviews with practitioners and parents were conducted. The findings were shared with a working group who co-designed amendments to the service guidance and resources.

The co-designed service guidance included checklists to assess suitability for parent administered dressing changes, how to offer and perform dressing changes, and post-clinic support, and a parent leaflet and video on administering dressing changes. Contents were designed to support the practical, psychological, and social elements of dressing changes. The service guidance was implemented across the three sites. In clinic observations, practitioners appeared more confident and informative when offering and supporting families to administer dressings.

Using experience-based co-design to develop service improvements across three paediatric burns services was effective in reaching consensus on best practice. While each burns service was different, they experienced commonalties making the co-designed service guidance suitable to apply across different paediatric burns services. The service guidance offers a competency framework for paediatric burns nursing practice standards to support parent administer home dressings.