School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.
BMJ Open. 2023 Aug 28;13(8):e068174. doi: 10.1136/bmjopen-2022-068174.
The objectives were to categorise the evidence, map out the existing studies and explore what was known about the organisation of paediatric intensive care units (PICUs) during the first 18 months of the COVID-19 pandemic. Additionally, this review set out to identify any knowledge gaps in the literature and recommend areas for future research.
Scoping review.
This study used Arksey and O'Malley's six-stage scoping review framework. A comprehensive search was conducted using the following databases, CINAHL Complete; MEDLINE; PsycINFO; PsycARTICLES and EMBASE and grey literature search engines. A search strategy with predefined inclusion criteria was used to uncover relevant research in this area. Screening and data collection were done in duplicate.
47 631 articles were obtained through searching. However, only 25 articles met the inclusion criteria and were included in the analysis. Three dominant themes emerged from the literature: (1) the reorganisation of space for managing increased capacity; (2) increased staffing and support; and (3) the resulting challenges.
COVID-19 has strained institutional resources across the globe. To relieve the burden on intensive care units (ICUs), some PICUs adjusted their units to care for critically ill adults, with other PICUs making significant changes, including the redeployment of staff to adult ICUs to provide extra care for adults. Overall, PICUs were collectively well equipped to care for adult patients, with care enhanced by implementing elements of holistic, family-centred PICU practices. The pandemic fostered a collaborative approach among PICU teams and wider hospital communities. However, specific healthcare guidelines had to be created to safely care for adult patients.
本研究旨在对 COVID-19 大流行的前 18 个月期间儿科重症监护病房（PICU）的组织情况进行分类、绘制现有研究图谱，并探索相关知识。此外，本综述还旨在确定文献中的知识空白，并为未来研究推荐领域。
范围综述。
本研究采用 Arksey 和 O'Malley 的六阶段范围综述框架。使用以下数据库进行全面检索：CINAHL Complete、MEDLINE、PsycINFO、PsycARTICLES 和 EMBASE 以及灰色文献搜索引擎。使用预设纳入标准的搜索策略来发现该领域的相关研究。筛查和数据收集均由两人完成。
通过检索共获得 47631 篇文章，但仅有 25 篇文章符合纳入标准并纳入分析。文献中出现了三个主要主题：（1）重新组织空间以管理增加的容量；（2）增加人员配备和支持；（3）由此产生的挑战。
COVID-19 使全球机构资源紧张。为缓解重症监护病房（ICU）的负担，一些 PICU 调整了其病房以照顾危重症成人，其他 PICU 则进行了重大调整，包括将工作人员重新部署到成人 ICU 以提供额外的成人护理。总体而言，PICU 有能力共同照顾成年患者，通过实施整体、以家庭为中心的 PICU 实践的要素来增强护理。大流行促进了 PICU 团队和更广泛医院社区之间的协作方法。但是，必须制定具体的医疗保健指南以安全地照顾成年患者。
