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CS135
Family Centered Care in the PICU: Implementing the American College of Critical Care Medicine Clinical Practice Guidelines
By: L. Hagan & P. Harmon; Sinai Hospital of Baltimore, Baltimore, MD
For further information, please contact: lhagan@lifebridgehealth.org
Purpose: Since nurses play a major role in helping families tolerate the indescribable experience of their child’s critical illness, PICU staff sought to implement evidence-based practices for improving family centered care.
Description: Parents in PICU’s play a fundamental role in providing for their child’s needs, yet historically they have often felt uninformed and alienated. The literature provides ample evidence for the causes of parental stress in the PICU including difficulties in communication with the healthcare team and changes in their role as parents. A multidisciplinary Family-Centered Care Committee in the PICU was convened and determined that implementing the clinical practice guidelines for support of the family in the patient-centered intensive care unit could help parents become active partners in decision-making and care. The group examined the recommendations which include decision-making, family coping, stress related to family interactions, cultural support, spiritual and religious support, visitation, environment of care, presence on rounds, presence at resuscitation, and palliative care. Based on these guidelines, the parents are considered members of the multidisciplinary team which has strengthened the integration of family-centered care into the culture and functioning of the PICU. A new parenting guideline has been developed which avoids the use of the word visiting with the philosophy that parents are not visiting; they are parenting.
Evaluation and Outcomes: Thirty-four recommendations in the clinical practice guidelines have been implemented in the PICU with planning for implementing the others as appropriate. Since the implementation of this program, parents have reported increased satisfaction with care and decreased feelings of being alienated from the team. The parents report a high level of satisfaction with the degree of integration within the PICU.
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