Edge Hill University, Ormskirk, UK.
Edge Hill University and Alder Hey Children's Hospital, Liverpool, UK.
Eur J Pediatr. 2023 Oct;182(10):4707-4721. doi: 10.1007/s00431-023-05131-9. Epub 2023 Aug 11.
Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020-2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds. Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child. What is Known: • Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. • Professionals report uncertainty and tensions in applying evidence-based practice to children's procedural care. What is New: • This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives. • The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.
尽管越来越多的证据表明需要改善以儿童为中心的护理服务，但儿童在接受临床治疗时仍会继续受到伤害。国际 ISupport 合作旨在制定标准，以概述和解释在临床治疗过程中儿童的良好治疗实践和权利。基于权利的儿童接受测试、治疗、调查、检查和干预的标准是使用迭代、多阶段、多方法和多利益相关者共识构建方法制定的。这种共识方法使用了一系列在线和面对面的方法，跨越三个阶段，以确保与多个利益相关者持续接触。203 名儿童和年轻人、78 名家长和 418 名多学科专业人员在两年期间（2020-2022 年）的意见和观点，为制定国际儿童测试、治疗、检查和干预护理的基于权利的标准提供了信息。这些标准是第一个就支持性和约束性约束的定义达成国际多利益相关者共识的标准。 结论：这是第一项从多利益相关者角度概述基于权利的程序护理标准的此类研究。这些标准为卫生专业人员和教育工作者提供了明确的循证工具，以支持讨论和实践变革，挑战对约束或限制儿童的普遍假设，转而鼓励关注儿童的利益和权利。 已知： • 尽管越来越多的证据表明需要改善以儿童为中心的护理服务，但儿童在接受临床治疗时仍会继续受到短期和长期的伤害。 • 专业人员报告在将循证实践应用于儿童程序护理时存在不确定性和紧张情绪。 新内容： • 这是第一项从多利益相关者角度制定国际基于权利的程序护理标准的此类研究。 • 这些标准是第一个就支持性和约束性约束的定义达成国际多利益相关者共识的标准。
