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ABSTRACT 211: BENEFITS OF PSYCHOSOCIAL SUPPORT ON A PAEDIATRIC INTENSIVE CARE UNIT

Wood, D.L.B.1; Abbas, K.1; Waddington, H.1; Shroff, P.1; Rose, E.1; Pierce, C.M.1

Pediatric Critical Care Medicine: May 2014 - Volume 15 - Issue 4_suppl - p 51
doi: 10.1097/01.pcc.0000448937.09929.16
Abstracts of the 7th World Congress on Pediatric Critical Care
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1Paediatric and Neonatal Intensive Care Units, Great Ormond Street Hospital, London, United Kingdom

Background and aims: Although outcomes in terms of physical health after PICU admission are improving, clinicians increasingly recognise psychological morbidity in survivors and their families.

Aims: We aimed to demonstrate how using parent feedback can improve the families’ experience on PICU.

Methods: Detailed notes from meetings over 10 years were analysed and each discussion topic coded. Codes were categorized into common themes and the frequency of each theme compared over time.

Results: Satisfaction with the quality of medical and nursing care was unchanged throughout the study period. Over time, there was a change from negative to positive comments on availability and quality of psychosocial support, including Family Liaison Nurses, designated psychologist and hospital chaplains. Other positive changes included: more encouragement to stay with their child, better information at admission and better communication with, and continuity of care by, the PICU Consultants. Consistent negative themes included practical and psychological difficulties around PICU discharge, concerns about support for siblings; parents’ presence on ward rounds; and dissatisfaction with parent facilities. Concerns that increased more recently included distress at separation from their child during procedures/resuscitation; delays in opening security doors; and financial difficulties related to being resident in the hospital.

Conclusions: Changes instituted as a direct result of parent feedback have correlated with measurable positive changes in the family experience. Challenges remain, particularly around providing support at discharge. Societal changes and expectations mean that new concerns emerge. As we improve survival of critically ill children, we have a responsibility to support any resulting psychological difficulties.

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies