• Am. J. Crit. Care · Jan 2018

    Nurses' Reflections on Benefits and Challenges of Implementing Family-Centered Care in Pediatric Intensive Care Units.

    • Heather Coats, Erica Bourget, Helene Starks, Taryn Lindhorst, Shigeko Saiki-Craighill, Curtis J Randall JR Heather Coats is an assistant professor of research, University of Colorado College of Nursing, Denver, Colorado. Erica Bourget is a research assistan, Ross Hays, and Ardith Doorenbos.
    • Heather Coats is an assistant professor of research, University of Colorado College of Nursing, Denver, Colorado. Erica Bourget is a research assistant at the Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington. Helene Starks is an associate professor, Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, Washington. Taryn Lindhorst is a professor, University of Washington School of Social Work, Seattle, Washington. Shigeko Saiki-Craighill is a professor, Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan. J. Randall Curtis is a professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine. Ross Hays is a professor in the Center for Child Health, Behavior and Development, Seattle Children's Research Institute, and in the Department of Rehabilitative Medicine, University of Washington School of Medicine. Ardith Doorenbos is a professor in the Department of Biobehavioral Nursing and Health Systems, University of Washington School of Nursing; the Department of Bioethics and Humanities, University of Washington School of Medicine; and the Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine.
    • Am. J. Crit. Care. 2018 Jan 1; 27 (1): 52-58.

    BackgroundFamily-centered care is a proposed way of supporting family involvement with a child's care and decreasing distress associated with a child's critical illness by improving communication, helping manage stress and coping, and decreasing conflicts. Nurses are critical to successful implementation of family-centered care.ObjectivesTo describe nurses' perceptions of the benefits and challenges of providing family-centered care in pediatric intensive care units.MethodsSemistructured interviews of 10 bedside and charge nurses in pediatric, cardiac, and neonatal intensive care units. Questions were related to 4 domains: the intensive care unit environment and its relationship to the structure and delivery of critical care, stressors for nurses and families, communication challenges and strategies, and involvement of families in care and decision-making.ResultsThe main thematic finding was the nurses' descriptions of a "balancing act" to provide quality family-centered care. The balancing act was characterized by the interaction between 2 types of changes: (1) intensive care unit policies related to visitation hours and family presence at the bedside and (2) physical transformations in the intensive care unit from shared open space to individual private rooms.ConclusionsAll of the nurses viewed the transition to family-centered care as having benefits for families. They also described how changes had created new challenges for the delivery of nursing care in intensive care units, particularly regarding mentorship and the safety of patients and staff.©2018 American Association of Critical-Care Nurses.

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