Phipps Lorri M, Bartke Cheryl N, Spear Debra A, Jones Linda F, Foerster Carolyn P, Killian Marie E, Hughes Jennifer R, Hess Joseph C, Johnson David R, Thomas Neal J
Division of Nursing, Department of Pediatrics, Penn State Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Pediatr Crit Care Med. 2007 May;8(3):220-4. doi: 10.1097/01.PCC.0000262798.84416.C5.
There is a paucity of literature evaluating the effects of family member presence during bedside medical rounds in the pediatric intensive care unit. We hypothesized that, when compared with rounds without family members, parental presence during morning medical rounds would increase time spent on rounds, decrease medical team teaching/education, increase staff dissatisfaction, create more stress in family members, and violate patient privacy in our open unit.
Prospective, blinded, observational study.
Academic pediatric intensive care unit with 12 beds.
A total of 105 admissions were studied, 81 family members completed a survey, and 187 medical team staff surveys were completed.
Investigators documented parental presence and time allocated for presentation, teaching, and answering questions. Surveys related to perception of goals, teaching, and privacy of rounds were distributed to participants.
Time spent on rounds, time spent teaching on rounds, and medical staff and family perception of the effects of parental presence on rounds.
There was no significant difference between time spent on rounds in the presence or absence of family members (p = NS). There is no significant difference between the time spent teaching by the attending physician in the presence or absence of family members (p = NS). Overall, parents reported that the medical team spent an appropriate amount of time discussing their child and were not upset by this discussion. Parents did not perceive that their own or their child's privacy was violated during rounds. The majority of medical team members reported that the presence of family on rounds was beneficial.
Parental presence on rounds does not seem to interfere with the educational and communication process. Parents report satisfaction with participation in rounds, and privacy violations do not seem to be a concern from their perspective.
评估家庭成员在儿科重症监护病房床边查房期间在场的影响的文献较少。我们假设，与无家庭成员在场的查房相比，晨间查房时家长在场会增加查房时间、减少医疗团队的教学/教育、增加工作人员的不满、给家庭成员带来更多压力，并在我们开放式病房中侵犯患者隐私。
前瞻性、盲法观察性研究。
拥有12张床位的学术性儿科重症监护病房。
共研究了105例入院病例，81名家庭成员完成了一项调查，187名医疗团队工作人员完成了调查。
研究人员记录了家长在场情况以及用于汇报、教学和答疑的时间。向参与者发放了与查房目标、教学和隐私认知相关的调查问卷。
查房时间、查房教学时间以及医务人员和家庭成员对家长在场对查房影响的认知。
有或无家庭成员在场时的查房时间无显著差异（p = 无显著性差异）。有或无家庭成员在场时主治医生的教学时间无显著差异（p = 无显著性差异）。总体而言，家长报告称医疗团队花了适当时间讨论他们孩子的情况，且并未因该讨论而感到不安。家长并未感觉到查房期间他们自己或孩子的隐私受到侵犯。大多数医疗团队成员报告称查房时有家庭成员在场是有益的。
家长在场查房似乎不会干扰教育和沟通流程。家长对参与查房表示满意，从他们的角度来看，隐私侵犯似乎不是一个问题。
