Parental Presence at the Bedside of Critically Ill Children in a Unit With Unrestricted Visitation

Jennifer R. Foster; Farhana I. AlOthmani; Jamie A. Seabrook; Tariq AlOfisan; Yasser M. AlGarni; Amrita Sarpal

doi:10.1097/PCC.0000000000001597

Parental Presence at the Bedside of Critically Ill Children in a Unit With Unrestricted Visitation

Jennifer R. Foster, Farhana I. AlOthmani, Jamie A. Seabrook, Tariq AlOfisan, Yasser M. AlGarni, Amrita Sarpal

Medicine

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Objectives: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. Design: Prospective cohort study. Setting: PICU in a single tertiary care children's hospital. Subjects: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015. Interventions: None. Measurement and Main Results: A total of 111 observations of 108 unique PICU admissions and families were performed. Children had at least one parent present a mean of 58.2% (sd, 34.6%) of the time. Mothers spent more time at the bedside (56.3% [sd, 31.0%]) than fathers (37.3% [sd, 29.5%]) (p = 0.0001). Percent of time with parental presence at the bedside was positively correlated with age (rs = 0.23; p = 0.02) and negatively associated with Pediatric Risk of Mortality III score (rs = -0.26; p = 0.01). Percent of time with parental presence at the bedside was lower for children who were mechanically ventilated (42.8% [sd, 35.5%]) than not (64.5% [sd, 32.2%]) (p = 0.01) and whose parent(s) were single (45.5% [sd, 27.5%]) or cohabitating/common-law (35.7% [sd, 26.4%]) compared with parents who were married (64.2% [sd, 34.2%]) or separated/divorced (68.3% [sd, 28.8%]) (p = 0.02). Percent of time with parental presence at the bedside was higher for children with chronic illnesses (63.4% [sd, 32.9%] vs 50.1% [sd, 35.8%] without; p = 0.04), when there was a bed in the patient room (61.4% [sd, 34.0%] vs 32.5% [sd, 28.3%] without; p = 0.01), and when parents slept in the patient room (90.3% [sd, 11.2%]) compared with their own home (37.6% [sd, 34.4%]) (p < 0.0001). Percent of time with parental presence at the bedside was not correlated with day of PICU stay, number of siblings, previous PICU admission, isolation status, or nursing ratio. Conclusions: Children had a parent present at the bedside approximately 60% of the time. The parents of younger, sicker children may benefit from supportive interventions during PICU admission. Further research is needed to examine both extrinsic and intrinsic factors affecting parental presence at the bedside.

Original language	English
Pages (from-to)	E387-E393
Journal	Pediatric Critical Care Medicine
Volume	19
Issue number	8
DOIs	https://doi.org/10.1097/PCC.0000000000001597
Publication status	Published - Aug 1 2018

Bibliographical note

Funding Information:
1Department of Paediatrics, Western University, London, ON, Canada. 2Department of Critical Care, Dalhousie University, Halifax, NS, Canada. 3Children’s Health Research Institute, London, ON, Canada. 4Lawson Health Research Institute, London, ON, Canada. 5Department of Pediatrics, Royal Hospital, Muscat, Oman. 6School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON, Canada. 7Department of Epidemiology and Biostatistics, Western University, London, ON, Canada. 8Human Environments Analysis Laboratory, Western University, London, ON, Canada. 9Division of Pediatric Intensive Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 10Department of Pediatrics, Imam Abdulrahman Bin Faisal University, Col-lege of Medicine, Dammam, Saudi Arabia. This work was performed at Children’s Hospital, London Health Sciences Centre and Western University. Supported, in part, by a resident research grant from the Department of Pediatrics, Western University. All authors received funding from a Resident Research Grant, Department of Pediatrics, Western University. Dr. Sarpal received funding from Academic Medical Organization of Southwestern Ontario (palliative care education project), Lawson Health Research Institute (perceptions of healthcare providers about inappropriate ongoing treatment in the PICU), Department of Pediatrics Western University (End of Life Care - Before and After the development of a Specialized Pediatric Palliative Care Service), and grant support through the Royal College of Physicians and Surgeons (Professional Development Grant), Western University (Mini-Fellowship), and Clinical Teaching Association Faculty Development Fund, which were received in relation to Critically ill children want their parents at the bed-the Art and Science of Coaching through Erickson Coaching International. side and feel less anxious when they are present (1). University Avenue, PO Box 9700, Halifax, NS, B3K6R8, Canada. E-mail: Address requests for reprints to: Jennifer Foster, MD, FRCPC, 5850/5980 Although the parents of hospitalized children on gen-jennifer.foster@iwk.nshealth.ca eral inpatient wards tend to stay with their child during wak-

Publisher Copyright:
© 2018 Lippincott Williams and Wilkins. All rights reserved.

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health
Critical Care and Intensive Care Medicine

Access to Document

10.1097/PCC.0000000000001597

Cite this

@article{f0d8384912ea472ca6035c85b39c225a,

title = "Parental Presence at the Bedside of Critically Ill Children in a Unit With Unrestricted Visitation",

abstract = "Objectives: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. Design: Prospective cohort study. Setting: PICU in a single tertiary care children's hospital. Subjects: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015. Interventions: None. Measurement and Main Results: A total of 111 observations of 108 unique PICU admissions and families were performed. Children had at least one parent present a mean of 58.2% (sd, 34.6%) of the time. Mothers spent more time at the bedside (56.3% [sd, 31.0%]) than fathers (37.3% [sd, 29.5%]) (p = 0.0001). Percent of time with parental presence at the bedside was positively correlated with age (rs = 0.23; p = 0.02) and negatively associated with Pediatric Risk of Mortality III score (rs = -0.26; p = 0.01). Percent of time with parental presence at the bedside was lower for children who were mechanically ventilated (42.8% [sd, 35.5%]) than not (64.5% [sd, 32.2%]) (p = 0.01) and whose parent(s) were single (45.5% [sd, 27.5%]) or cohabitating/common-law (35.7% [sd, 26.4%]) compared with parents who were married (64.2% [sd, 34.2%]) or separated/divorced (68.3% [sd, 28.8%]) (p = 0.02). Percent of time with parental presence at the bedside was higher for children with chronic illnesses (63.4% [sd, 32.9%] vs 50.1% [sd, 35.8%] without; p = 0.04), when there was a bed in the patient room (61.4% [sd, 34.0%] vs 32.5% [sd, 28.3%] without; p = 0.01), and when parents slept in the patient room (90.3% [sd, 11.2%]) compared with their own home (37.6% [sd, 34.4%]) (p < 0.0001). Percent of time with parental presence at the bedside was not correlated with day of PICU stay, number of siblings, previous PICU admission, isolation status, or nursing ratio. Conclusions: Children had a parent present at the bedside approximately 60% of the time. The parents of younger, sicker children may benefit from supportive interventions during PICU admission. Further research is needed to examine both extrinsic and intrinsic factors affecting parental presence at the bedside.",

author = "Foster, {Jennifer R.} and AlOthmani, {Farhana I.} and Seabrook, {Jamie A.} and Tariq AlOfisan and AlGarni, {Yasser M.} and Amrita Sarpal",

note = "Funding Information: 1Department of Paediatrics, Western University, London, ON, Canada. 2Department of Critical Care, Dalhousie University, Halifax, NS, Canada. 3Children{\textquoteright}s Health Research Institute, London, ON, Canada. 4Lawson Health Research Institute, London, ON, Canada. 5Department of Pediatrics, Royal Hospital, Muscat, Oman. 6School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON, Canada. 7Department of Epidemiology and Biostatistics, Western University, London, ON, Canada. 8Human Environments Analysis Laboratory, Western University, London, ON, Canada. 9Division of Pediatric Intensive Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 10Department of Pediatrics, Imam Abdulrahman Bin Faisal University, Col-lege of Medicine, Dammam, Saudi Arabia. This work was performed at Children{\textquoteright}s Hospital, London Health Sciences Centre and Western University. Supported, in part, by a resident research grant from the Department of Pediatrics, Western University. All authors received funding from a Resident Research Grant, Department of Pediatrics, Western University. Dr. Sarpal received funding from Academic Medical Organization of Southwestern Ontario (palliative care education project), Lawson Health Research Institute (perceptions of healthcare providers about inappropriate ongoing treatment in the PICU), Department of Pediatrics Western University (End of Life Care - Before and After the development of a Specialized Pediatric Palliative Care Service), and grant support through the Royal College of Physicians and Surgeons (Professional Development Grant), Western University (Mini-Fellowship), and Clinical Teaching Association Faculty Development Fund, which were received in relation to Critically ill children want their parents at the bed-the Art and Science of Coaching through Erickson Coaching International. side and feel less anxious when they are present (1). University Avenue, PO Box 9700, Halifax, NS, B3K6R8, Canada. E-mail: Address requests for reprints to: Jennifer Foster, MD, FRCPC, 5850/5980 Although the parents of hospitalized children on gen-jennifer.foster@iwk.nshealth.ca eral inpatient wards tend to stay with their child during wak- Publisher Copyright: {\textcopyright} 2018 Lippincott Williams and Wilkins. All rights reserved.",

year = "2018",

month = aug,

day = "1",

doi = "10.1097/PCC.0000000000001597",

language = "English",

volume = "19",

pages = "E387--E393",

journal = "Pediatric Critical Care Medicine",

issn = "1529-7535",

publisher = "Lippincott Williams and Wilkins",

number = "8",

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T1 - Parental Presence at the Bedside of Critically Ill Children in a Unit With Unrestricted Visitation

AU - Foster, Jennifer R.

AU - AlOthmani, Farhana I.

AU - Seabrook, Jamie A.

AU - AlOfisan, Tariq

AU - AlGarni, Yasser M.

AU - Sarpal, Amrita

N1 - Funding Information: 1Department of Paediatrics, Western University, London, ON, Canada. 2Department of Critical Care, Dalhousie University, Halifax, NS, Canada. 3Children’s Health Research Institute, London, ON, Canada. 4Lawson Health Research Institute, London, ON, Canada. 5Department of Pediatrics, Royal Hospital, Muscat, Oman. 6School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON, Canada. 7Department of Epidemiology and Biostatistics, Western University, London, ON, Canada. 8Human Environments Analysis Laboratory, Western University, London, ON, Canada. 9Division of Pediatric Intensive Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 10Department of Pediatrics, Imam Abdulrahman Bin Faisal University, Col-lege of Medicine, Dammam, Saudi Arabia. This work was performed at Children’s Hospital, London Health Sciences Centre and Western University. Supported, in part, by a resident research grant from the Department of Pediatrics, Western University. All authors received funding from a Resident Research Grant, Department of Pediatrics, Western University. Dr. Sarpal received funding from Academic Medical Organization of Southwestern Ontario (palliative care education project), Lawson Health Research Institute (perceptions of healthcare providers about inappropriate ongoing treatment in the PICU), Department of Pediatrics Western University (End of Life Care - Before and After the development of a Specialized Pediatric Palliative Care Service), and grant support through the Royal College of Physicians and Surgeons (Professional Development Grant), Western University (Mini-Fellowship), and Clinical Teaching Association Faculty Development Fund, which were received in relation to Critically ill children want their parents at the bed-the Art and Science of Coaching through Erickson Coaching International. side and feel less anxious when they are present (1). University Avenue, PO Box 9700, Halifax, NS, B3K6R8, Canada. E-mail: Address requests for reprints to: Jennifer Foster, MD, FRCPC, 5850/5980 Although the parents of hospitalized children on gen-jennifer.foster@iwk.nshealth.ca eral inpatient wards tend to stay with their child during wak- Publisher Copyright: © 2018 Lippincott Williams and Wilkins. All rights reserved.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Objectives: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. Design: Prospective cohort study. Setting: PICU in a single tertiary care children's hospital. Subjects: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015. Interventions: None. Measurement and Main Results: A total of 111 observations of 108 unique PICU admissions and families were performed. Children had at least one parent present a mean of 58.2% (sd, 34.6%) of the time. Mothers spent more time at the bedside (56.3% [sd, 31.0%]) than fathers (37.3% [sd, 29.5%]) (p = 0.0001). Percent of time with parental presence at the bedside was positively correlated with age (rs = 0.23; p = 0.02) and negatively associated with Pediatric Risk of Mortality III score (rs = -0.26; p = 0.01). Percent of time with parental presence at the bedside was lower for children who were mechanically ventilated (42.8% [sd, 35.5%]) than not (64.5% [sd, 32.2%]) (p = 0.01) and whose parent(s) were single (45.5% [sd, 27.5%]) or cohabitating/common-law (35.7% [sd, 26.4%]) compared with parents who were married (64.2% [sd, 34.2%]) or separated/divorced (68.3% [sd, 28.8%]) (p = 0.02). Percent of time with parental presence at the bedside was higher for children with chronic illnesses (63.4% [sd, 32.9%] vs 50.1% [sd, 35.8%] without; p = 0.04), when there was a bed in the patient room (61.4% [sd, 34.0%] vs 32.5% [sd, 28.3%] without; p = 0.01), and when parents slept in the patient room (90.3% [sd, 11.2%]) compared with their own home (37.6% [sd, 34.4%]) (p < 0.0001). Percent of time with parental presence at the bedside was not correlated with day of PICU stay, number of siblings, previous PICU admission, isolation status, or nursing ratio. Conclusions: Children had a parent present at the bedside approximately 60% of the time. The parents of younger, sicker children may benefit from supportive interventions during PICU admission. Further research is needed to examine both extrinsic and intrinsic factors affecting parental presence at the bedside.

AB - Objectives: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. Design: Prospective cohort study. Setting: PICU in a single tertiary care children's hospital. Subjects: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015. Interventions: None. Measurement and Main Results: A total of 111 observations of 108 unique PICU admissions and families were performed. Children had at least one parent present a mean of 58.2% (sd, 34.6%) of the time. Mothers spent more time at the bedside (56.3% [sd, 31.0%]) than fathers (37.3% [sd, 29.5%]) (p = 0.0001). Percent of time with parental presence at the bedside was positively correlated with age (rs = 0.23; p = 0.02) and negatively associated with Pediatric Risk of Mortality III score (rs = -0.26; p = 0.01). Percent of time with parental presence at the bedside was lower for children who were mechanically ventilated (42.8% [sd, 35.5%]) than not (64.5% [sd, 32.2%]) (p = 0.01) and whose parent(s) were single (45.5% [sd, 27.5%]) or cohabitating/common-law (35.7% [sd, 26.4%]) compared with parents who were married (64.2% [sd, 34.2%]) or separated/divorced (68.3% [sd, 28.8%]) (p = 0.02). Percent of time with parental presence at the bedside was higher for children with chronic illnesses (63.4% [sd, 32.9%] vs 50.1% [sd, 35.8%] without; p = 0.04), when there was a bed in the patient room (61.4% [sd, 34.0%] vs 32.5% [sd, 28.3%] without; p = 0.01), and when parents slept in the patient room (90.3% [sd, 11.2%]) compared with their own home (37.6% [sd, 34.4%]) (p < 0.0001). Percent of time with parental presence at the bedside was not correlated with day of PICU stay, number of siblings, previous PICU admission, isolation status, or nursing ratio. Conclusions: Children had a parent present at the bedside approximately 60% of the time. The parents of younger, sicker children may benefit from supportive interventions during PICU admission. Further research is needed to examine both extrinsic and intrinsic factors affecting parental presence at the bedside.

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Parental Presence at the Bedside of Critically Ill Children in a Unit With Unrestricted Visitation

Abstract

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