The Impact of Parental Presence on Invasive Procedures in the Pediatric Emergency Department: A Prospective Study

Nurses' views on the presence of family members during invasive procedures in hospitalised children: A questionnaire survey

AIMS AND OBJECTIVES

(I) To identify the opinion and practices of nursing professionals regarding the presence of family members during invasive procedures in hospitalised children; (II) to determine the knowledge of nursing professionals about the patient-and family-centred care model.

BACKGROUND

Family presence in invasive procedures benefits the patient and their relatives, but varied attitudes exist among healthcare personnel, with some being favourable and others unfavourable toward family presence.

DESIGN

Observational, descriptive, cross-sectional study.

METHODS

Study population: Nurses from paediatric critical care services, emergency services, hospital wards, day hospitals and outpatient clinics at a Catalan tertiary hospital who participated voluntarily between September 2021 and July 2022. Data collection instrument: A questionnaire prepared by the researchers, based on the literature and reviewed by experts. REDCap link with access to the questionnaire was sent out to potential respondents through the institutional email. Bivariate analysis was performed with the R 4.2 program. The study was approved by the hospital's Clinical Research Committee and participants gave informed consent before responding to the questionnaire.

RESULTS

A total of 172 nurses participated, and 155 valid responses were obtained. All respondents consider the family as a key element in paediatric care and report inviting family members to participate in the care given to their child. However, 12.0% of nurses do not invite the family to be present in invasive procedures. Almost all respondents note the need for training to acquire communication skills and improve the management of emotions.

CONCLUSIONS

The results show a favourable opinion towards the presence of family members and highlight the need to train nurses to develop communication skills.

RELEVANCE TO CLINICAL PRACTICE

The data provided can favour the design of measures to improve and promote the presence of parents during invasive procedures, reinforcing the patient-and family-centred care model and improving the quality of care provided. One example is the creation of family care protocols where the inclusion of parents and the roles of each individual involved in the care process appears.

Challenges and facilitators in child-friendly healthcare from the perspective of pediatric emergency nurses: A qualitative study

PURPOSE

This study aimed to determine pediatric emergency nurses' experiences and opinions regarding child-friendly care within Watson's Human Care Model framework.

DESIGN AND METHODS

This study is qualitative research conducted with nurses in the pediatric emergency unit of a university hospital between 06 March and 06 April 2024. This study used a purposive sampling method and conducted semi-structured interviews with 17 nurses. All interviews were audio recorded and transcribed. Inductive thematic analysis method was used. The study was written based on the COREQ checklist.

FINDINGS

This study determined two themes, five sub-themes, and 13 categories. The theme "challenges to child-friendly healthcare implementation" included a lack of physical space and agitated and violent families. It has been reported that physical space, especially where privacy is not protected, makes child-friendly care complex, and the violent reactions of families are significant obstacles. The second theme, "facilitators for an ideal child-friendly pediatric emergency unit," included the design of the pediatric emergency unit/improving physical environment, availability of appropriate equipment, and effective communication strategies. This theme emphasizes the importance of colorfully designing the physical space and equipment in a way that does not scare children.

CONCLUSION

It has been determined that the healing environment and care processes are essential for child-friendly care. During the care processes, communication according to the age of the children and communication with agitated families was emphasized as an essential component of care.

PRACTICE IMPLICATIONS

The study results will guide hospital management, healthcare professionals working in the field, and future studies on designing the child-friendly emergency unit that children deserve.