Paediatric Intensive Care, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France.
Department of Child and Adolescent Mental Health, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon-Bron, France.
Nurs Crit Care. 2021 Jul;26(4):288-296. doi: 10.1111/nicc.12567. Epub 2020 Oct 23.
Many critically ill children can be fed orally at some point during their paediatric intensive care (PICU) stay, but reduced appetite and other factors may impact their intake. At home, oral feeding is usually delivered by parents, so involving parents more actively during mealtimes in the PICU may contribute to improved patient/family satisfaction.
To assess the impact of a new "room service" initiative involving parents on mealtime quality and on both family and health care professional (HCP) satisfaction.
A prospective, single-centre, before-and-after intervention study was designed as part of a PICU quality-of-care improvement programme in 2013 to 2016. Two questionnaires assessing oral nutrition practices and family/HCP overall satisfaction were disseminated among the parents of critically ill children capable of oral feeding during their PICU admission and among the whole PICU HCP team (nurses, nurse assistants, and medical doctors). Categorical variables were compared using the chi-square test, and Likert scales were compared between groups with the Mann-Whitney-Wilcoxon test.
the pre-intervention surveys were completed by 97 of 130 (75%) HCPs and 52 families and the post-intervention surveys by 74 of 130 (57%) HCPs and 54 families. After the intervention, a marked improvement was observed in the overall quality of meal service rating by both HCPs and families (medians and IQR: 5 (5-7) to 7 (7, 8) and 6 (6-8) to 8 (7-9), respectively; P < .01) and also in parents' involvement; in children's, families', and HCP satisfaction; in meal-dedicated facilities and equipment; and in perception that oral nutrition is an important aspect of PICU care.
Implementation of an improved "room service" initiative in the PICU was feasible and improved the perceived quality of care and satisfaction around oral feeding. This family-centred care initiative can be integrated in an overall quality improvement strategy.
许多危重症患儿在儿科重症监护病房（PICU）住院期间都可以进行口服喂养，但食欲减退和其他因素可能会影响他们的摄入量。在家中，通常由父母进行口服喂养，因此在 PICU 期间让父母更积极地参与用餐时间可能有助于提高患者/家庭的满意度。
评估一项新的“病房服务”计划对用餐质量以及家庭和医疗保健专业人员（HCP）满意度的影响。
作为 2013 年至 2016 年期间 PICU 质量改进计划的一部分，设计了一项前瞻性、单中心、前后干预研究。在 PICU 入院期间能够进行口服喂养的危重症患儿的父母以及整个 PICU HCP 团队（护士、护士助理和医生）中，分发了两份评估口服营养实践和家庭/HCP 整体满意度的问卷。使用卡方检验比较分类变量，使用 Mann-Whitney-Wilcoxon 检验比较组间 Likert 量表。
干预前调查完成了 130 名 HCP 中的 97 名（75%）和 52 个家庭，干预后调查完成了 130 名 HCP 中的 74 名（57%）和 54 个家庭。干预后，HCP 和家庭对膳食服务质量的总体评分均明显提高（中位数和 IQR：5（5-7）至 7（7，8）和 6（6-8）至 8（7-9）；P < 0.01），并且父母的参与度、儿童、家庭和 HCP 的满意度、专门的餐饮设施和设备以及对口服营养是 PICU 护理重要方面的看法也得到了改善。
在 PICU 实施改进的“病房服务”计划是可行的，并提高了对口服喂养的护理质量和满意度的感知。这种以家庭为中心的护理举措可以融入整体质量改进策略中。
