Nottingham Children's Hospital, Nottingham University Hospitals NUS Trust, Nottingham, UK.
Children and Young People's Health Research, School of Health Sciences, The University of Nottingham, Nottingham, UK.
Nurs Crit Care. 2021 Mar;26(2):128-134. doi: 10.1111/nicc.12510. Epub 2020 Apr 23.
The objective of this study was to examine the characteristic, content, and role of Paediatric Intensive Care Units (PICUs) in the provision of follow-up for children and their families' post-intensive care discharge in the United Kingdom (UK) and Republic of Ireland (RoI). The study followed a descriptive self-reported, web-based survey design. "In-hospital PICU follow-up" was defined as follow-up delivered by the PICU team following PICU discharge but before hospital discharge and "post-discharge PICU follow-up" was defined as follow-up delivered by the PICU team following hospital discharge. The survey was administered to all 28 PICUs in the UK and RoI. Paediatric intensive care medical directors or delegated individuals participated. Data were collected between September 2017 and January 2018 with a response rate of 79% (n = 22/28). Twelve units provided either in-hospital and/or post-discharge PICU follow-up. Ten (45%) PICUs reported providing in-hospital follow-up, with half (n = 5) using an eligibility criteria for in-hospital follow-up, which related to disease groups. The most frequently reported form of in-hospital PICU follow-up consisted of face-to-face patient consultation (n = 8) by a PICU doctor (n = 5) and/or nurse (n = 4). The time at which initial contact was made was usually not predetermined (n = 4) and the assessment of care needs included are tracheostomy care (n = 4), respiratory care (n = 4), and sedative medication weaning plan (n = 5). Four PICUs reported to provide post-discharge follow-up. This involved telephone (n = 2), follow-up clinic consultations (n = 1) or home visits (n = 1), provided predominantly by PICU doctors (n = 2), with their activity directed by patient needs (n = 3). Despite increasing evidence to suggest PICU survivors and their families experience negative sequalae post-PICU discharge, less than half of PICUs surveyed provide in-hospital follow-up and only a minority provide post-discharge follow-up. There is variation in the delivery, content, and format of in-hospital and post-discharge PICU follow-up in the UK and RoI.
本研究旨在探讨英国（UK）和爱尔兰共和国（RoI）儿科重症监护病房（PICU）在为儿童及其家庭提供重症监护后出院随访方面的特点、内容和作用。该研究采用描述性自我报告的网络调查设计。“院内 PICU 随访”是指 PICU 出院后但在出院前由 PICU 团队提供的随访，“出院后 PICU 随访”是指 PICU 出院后由 PICU 团队提供的随访。该调查面向 UK 和 RoI 的所有 28 个 PICU 进行。儿科重症监护医学主任或指定人员参与了调查。数据收集于 2017 年 9 月至 2018 年 1 月期间，回复率为 79%（n=22/28）。12 个单位提供了院内和/或出院后 PICU 随访。10 个（45%）PICU 报告提供了院内随访，其中一半（n=5）使用了与疾病组相关的院内随访的入选标准。最常报告的院内 PICU 随访形式是由 PICU 医生（n=5）和/或护士（n=4）进行面对面的患者咨询（n=8）。最初联系的时间通常不是预先确定的（n=4），护理需求评估包括气管造口护理（n=4）、呼吸护理（n=4）和镇静药物脱瘾计划（n=5）。4 个 PICU 报告提供出院后随访。这涉及电话（n=2）、随访诊所咨询（n=1）或家访（n=1），主要由 PICU 医生（n=2）提供，其活动根据患者需求而定（n=3）。尽管越来越多的证据表明 PICU 幸存者及其家属在 PICU 出院后会出现负面后遗症，但接受调查的 PICU 中不到一半提供院内随访，只有少数提供出院后随访。在 UK 和 RoI，院内和出院后 PICU 随访的提供、内容和形式存在差异。
