A comparison of nurses' and parents' or caregivers' perceptions during pediatric burn dressing changes: an exploratory study.

Providing emotional support both to children or young persons and to their parents or caregivers during pediatric burn dressing changes is a crucial aspect of nursing care in a burn unit; however, little research has examined perceptions of the effectiveness of typical interventions. Therefore, the aim of this research was to compare nurses' and parents' or caregivers' perceptions of support interventions provided before, during, and after pediatric burn dressing changes. This research was exploratory in nature and included the development of two differing questionnaires that focused on the perceptions of both parents or caregivers and nursing staff involved in dressing changes. Nurses and parents or caregivers involved in a total of 30 dressing changes completed surveys. Results were then analyzed using Microsoft Excel computer program, and a simple thematic analysis was performed on the responses to the open-ended survey questions. The survey results indicated that participants were generally favorable in their perceptions of the interventions used to support children during dressing changes; however, some gaps in the provision of care were identified. These included the need for clearer communication between the nurse and the parent or caregiver, poor pain assessment skills, and the need for debriefing for those involved in burn dressing procedures. Also highlighted were the difficulties nursing staff had in recognizing distress in parents or caregivers and when this occurred during the process. This research provided insights into coping strategies used by families and nurses and the value of support currently provided by the pediatric burn team. The results indicate that there is a need for improved communication with parents. The presence of a hospital play specialist, in addition to the parent or caregiver, was valuable. Also important was focusing on "comfort" positioning and use of distraction/alternative focus during dressing changes. The information gathered has provided additional strategies that can improve the care offered to children, young people, and families with burn injuries. Such strategies should be implemented in collaboration with the burn multidisciplinary team.