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The Challenges of Caring for Long-Stay Patients in the PICU

Geoghegan, S; Oulton, K; Bull, C; Brierley, J; Peters, M; Wray, J; (2016) The Challenges of Caring for Long-Stay Patients in the PICU. Pediatric Critical Care Medicine , 17 (6) e266-e271. 10.1097/PCC.0000000000000725. Green open access

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Abstract

OBJECTIVE: Compared to shorter-stay patients, caring for long-stay patients in the ICU entails a disproportionate burden for staff. Our objective was to gain a deeper understanding of the impact on staff of caring for children who have a prolonged stay on the PICU. DESIGN: Qualitative study based on semi-structured interviews. Data were analyzed using the Framework approach. SETTING: Children’s tertiary hospital. PARTICIPANTS: Seventeen members of staff (7 psychosocial staff, 7 nurses, 3 consultants) working in the PICU, neonatal ICU, or cardiac ICU (PICU will be used to encompass neonatal ICU, cardiac ICU, and PICU for the remainder of this article). INTERVENTIONS: Semi-structured, tape-recorded interviews. MEASUREMENTS AND MAIN RESULTS: Staff reported both positive and challenging aspects of caring for long-stay patients in the PICU. Five key areas relating to the challenges of caring for long-stay patients were identified: staff expectations about their work, characteristics of the patient group, the impact on staff, the impact on the wider unit, and the availability of support. Staff views were often compounded by individual cases they had been involved with or had heard about which fell at either end of the spectrum of “good” and “bad”. CONCLUSIONS: Whilst there are reported benefits associated with caring for long-stay patients, there are a number of challenges reported that may have implications for staff and the wider unit. When caring for a particular sub-group of long-stay patients, staff may be more likely to experience negative impacts. A key priority for the PICU is to ensure that support mechanisms are timely, accessible, and allow staff to explore their own reactions to their work.

Type: Article
Title: The Challenges of Caring for Long-Stay Patients in the PICU
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/PCC.0000000000000725
Publisher version: http://dx.doi.org/10.1097/PCC.0000000000000725
Language: English
Additional information: Copyright: © 2016 The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. This is a non-final version of an article published in final form in Pediatric Critical Care Medicine [Geoghegan, S et al (2016) The Challenges of Caring for Long-Stay Patients in the PICU. Pediatric Critical Care Medicine , 17 (6) e266-e271. 10.1097/PCC.0000000000000725]
Keywords: children, critical care, long-stay, qualitative, staff
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1506031
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