Aims and objectives:To understand how the pandemic environment impacted the delivery of FCC of children and families from a nursing perspective in a major tertiary paediatric hospital.Background: Family-centred care (FCC) is a well-established framework to promote parental involvement in every aspect of a child's hospitalization, however, rules and restrictions in place during the COVID-19 pandemic affected the ways in which Family-centred Care could be delivered in practice.Design: This is a qualitative exploratory descriptive study to elicit the perspective of paediatric nurses delivering care to children in a hospital during the COVID-19 pandemic in Victoria, Australia.
Methods:Nurses from all subspecialties in a tertiary paediatric hospital were invited to participate in virtual focus groups to discuss their experience of delivering FCC during the COVID-19 pandemic. Focus groups were recorded and transcribed, then analysed using Framework Analysis.
Results: Nineteen nurses participated across seven focus groups during June and July 2020. The four themes-Advocating with empathy, Enabling communication, Responding with flexibility, and Balancing competing considerations-and the eight subthemes that were generated, outline how nurses deliver FCC, and how these FCC actions were impacted by the COVID-19 environment and the related hospital restrictions. Conclusion: This study documents the experiences, resilience and resourcefulness of paediatric nurses in Australia during the COVID-19 pandemic as well as moving Family-centred Care from a theoretical framework into a practical reality. Impact: The findings from this study should inform consideration of the impacts of public health policies during infectious disease outbreaks moving forward. In addition by describing the core actions of Family-centred Care, this study has implications for educational interventions on how to translate FCC theory into practice.No public or patient contribution as this study explored nursing perceptions only.
Introduction: Evidence based suggestions to optimise nutrition delivery in the ICU include; (a) developing an EN protocol, (b) starting at target rate, (c) effective use of prokinetic agents, and (d) increasing the threshold for gastric-residual volumes (GRV) as a clinical indicator of EN intolerance. In November 2017, the Eastern Health (EH) ICU enteral feeding protocol was revamped to reflect all the above evidenc-based suggestions, as well as introducing a standardised feed break from 0700-1100 for all patients to allow for extubation and procedures that require fasting without compromising nutrition. Objectives/Aims: To audit the efficacy of the ICU enteral feeding protocol at improving nutrition provision across two EH ICUs. Methods: A retrospective medical record audit at 9-and 12-months post implementation of the revamped enteral feeding protocol was undertaken. The identification numbers of randomly selected patients that had been intubated for more than 48h were obtained and their medical records audited against the 20-h enteral feeding protocol.Results: Comparing pre-implementation audit results to 12-months post; EH ICUs fed 9h earlier (30 h versus 21 h), started at a feed rate 14ml/h higher (32ml/h versus 46ml/h) and provided 9% more nutrition overall (63% versus 72%). There were 4% less inappropriate feeding interruptions and the protocol was accepted with 100% compliance to the intermittent nature of feeding with a standardised 4h feed break to allow for extubation and investigations that require fasting without compromising nutrition. Conclusion: The 20-h enteral feeding protocol has proven effective at improving nutrition provision across EH ICUs. Further investigations should include a comparison of patient outcomes between those fed for 24h, and those fed for 20h.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.