In situ simulation training for parental presence during critical situations in PICU: an observational study

Alice Bordessoule,Francisca Barcos,Cristina Felice-Civitillo,Angelo Polito,Kevin Haddad,Peter C Rimensberger,Serge Grazioli

doi:10.1007/s00431-022-04425-8

Alice Bordessoule, Francisca Barcos + Show 5 more

Open Access

https://doi.org/10.1007/s00431-022-04425-8

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Abstract

Family presence during invasive procedures or cardiopulmonary resuscitation (CPR) is a part of the family-centered approach in pediatric intensive care units (PICUs). We established a simulation program aiming at providing communication tools to healthcare professionals. The goal of this study was to evaluate the impact of this program on the stress of PICU professionals and its acceptance. An observational study of a simulation program, with questionnaire, was used to measure pre- and post-simulation stress and the degree of satisfaction of the participants. PICU of Geneva Children’s Hospital, Switzerland. Forty simulations with four different simulation scenarios and various types of parental behavior, as imitated by professional actors, were completed during a 1-year period. Primary outcomes were the difference in perceived stress level before and after the simulation and the degree of satisfaction of healthcare professionals (nursing assistants, nurses, physicians). The impact of previous experience with family members during critical situations or CPR was evaluated by variation in perceived stress level. Overall, 201 questionnaires were analyzed. Perceived stress associated with parental presence decreased from a pre-simulation value of 6 (IQR, 4–7) to 4 (IQR, 2–5) post-simulation on a scale of 1–10. However, in 25.7% of cases, the individually perceived post-simulation stress level was higher than the pre-simulation one. Satisfaction of the participants was high with a median of 10 (IQR, 9–10) out of 10.Conclusions: A simulation program helps reduce PICU team emotional stress associated with the presence of family members during critical situations or CPR, and is welcomed by PICU team members.What is Known:• Family presence during cardiopulmonary resuscitation (CPR) or critical situations is a part of the family-centered approach in pediatric intensive care.• The benefits for the family have been already demonstrated. However, this policy is still controversy among healthcare professionals.What is New:• A simulation program seeking to provide skills focused on family presence management in the PICU is useful to reduce stress and was well accepted by participants.• It might become an indispensable training intervention for the implementation of a PICU policy to allow family presence during CPR or other critical situations.

Highlights

Patient- and family-centered care is an approach that underlines the essential role of family in patient healthcare and promotes a beneficial collaboration with healthcare professionals
A simulation program helps reduce pediatric intensive care units (PICUs) team emotional stress associated with the presence of family members during critical situations or cardiopulmonary resuscitation (CPR), and is welcomed by PICU team members
Presence during cardiopulmonary resuscitation (CPR) or critical situations is a part of the family-centered approach in pediatric intensive care

Summary

Introduction

Patient- and family-centered care is an approach that underlines the essential role of family in patient healthcare and promotes a beneficial collaboration with healthcare professionals. Parents are usually willing to be present and participate in the decision-making when invasive procedures are performed on their child [1] For this reason, family members’ presence during invasive procedures and cardiopulmonary resuscitation (CPR) has been proposed as an essential aspect of a family-centered approach to pediatric intensive care (PICU). Family interference with the team in charge of the patient has not been reported to be a frequent issue during CPR [4, 20] trauma evaluation or emergency procedures [14] For these reasons, in 2015, European Resuscitation Council Guidelines for Resuscitation promoted FP during resuscitation attempts [16]. Presence might be associated with negative experiences among healthcare professionals [19] For this reason, the guidelines for Family-Centered Care written for the Neonatal, Pediatric, and Adult ICU support training for this practice [21]. The aim of this study was to evaluate the impact of this simulation program on healthcare professionals’ stress and the satisfaction

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