Development and Implementation of a Protocol for In-Room Surgical Procedures in Paediatric Intensive Care

The Paediatric Intensive Care Unit (PICU) of a Swiss university hospital routinely performs surgical interventions directly in patient rooms due to certain patients' inability to be transferred to the operating room. Given the variability in practice, organizational delays and increased stress among healthcare professionals stemming from oral transmission of procedural knowledge, an institutional protocol was developed. This protocol aims to enhance care safety, improve interdisciplinary coordination and systematically anticipate material human, and environmental needs. Developed through structured methodology including semi-structured interviews with key stakeholders, it specifically addresses complex procedures such as Extracorporeal Membrane Oxygenation (ECMO) management, thoracic surgeries and postoperative cardiac revisions within intensive care settings. Its implementation is expected to significantly reduce perioperative complications, optimize ergonomics and logistics and improve overall care quality.