Assessment of parental presence during bedside pediatric intensive care unit rounds: Effect on duration, teaching, and privacy*

Phipps, Lorri M.; Bartke, Cheryl N; Spear, Debra; Jones, Lily; Foerster, Carolyn P.; Killian, Marie E; Hughes, Jennifer; Hess, Joseph; Johnson, David R.; Thomas, Neal J.

doi:10.1097/01.pcc.0000262798.84416.c5

Cited by 83 publications

(58 citation statements)

References 13 publications

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“…Our findings are more consistent with those of Kuo et al, 13 who reported that family participation during rounds was associated with higher parental satisfaction, improved and consistent transfer of medical information, discussion of care plan, and participation in decision making; and Phipps et al, 10 who reported that parental presence during rounds did not inhibit teaching. Our study also supports the finding of others that parental participation minimizes parental anxiety, builds trust, and improves communication and team building between the family and the medical team.…”

Section: Discussionsupporting

confidence: 83%

“…The initial concerns voiced by our CTICU staff, as well as in published reports, regarding privacy issues, increasing parental anxiety, increasing duration of rounds, decreasing teaching during rounds, and concerns for parents' understanding of complex discussions [8][9][10][11] were not found to be true in our experience. Our findings are more consistent with those of Kuo et al, 13 who reported that family participation during rounds was associated with higher parental satisfaction, improved and consistent transfer of medical information, discussion of care plan, and participation in decision making; and Phipps et al, 10 who reported that parental presence during rounds did not inhibit teaching.…”

Section: Discussionmentioning

confidence: 49%

“…Some concerns voiced by staff regarding inclusion of parents during rounds include privacy issues, increasing parents' anxiety, increasing duration of rounds, decreasing teaching during rounds, and concerns for parents' understanding of complex discussions. [8][9][10][11] Phipps et al, 10 in an observational study, showed that parental presence during rounds did not inhibit teaching during rounds, although admittedly the data on this topic are controversial. Cameron et al, 12 in a prospective, observational, and survey-based study, showed that 40% of attending physicians limited their teaching during rounds to avoid exposing the knowledge gaps among house staff.…”

mentioning

confidence: 99%

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Increasing Parental Participation During Rounds in a Pediatric Cardiac Intensive Care Unit

Blankenship

Harrison

Brandt

et al. 2015

American Journal of Critical Care

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Background Inviting parents of sick children to participate during the rounding process may reduce parents’ anxiety and improve communication between the parents and the health care team. Objectives To increase the percentage of available parents invited to participate in morning rounds in a pediatric cardiothoracic intensive care unit (CTICU). Methods Invitations to parents to participate in morning CTICU rounds were randomly audited from June 2012 to April 2014 (mean, 15 audits per month). From June 2012 to February 2013 (before intervention), 73% of parents available during morning rounds received an invitation to participate. From April 2013 to May 2013, the following interventions (family participation bundle) were implemented: (1) staff education, (2)“Invitation to Rounds” handout added to the parent welcome packet with verbal explanation, (3) bedside tool provided for parents to communicate desire to participate in rounds with the team, (4) reminder to invite parents added to nursing rounding sheet. Following interventions, family feedback was obtained by 1-on-1 (physician-parent) open-ended conversation. Results From April 2013 to April 2014, 94% of parents available during morning rounds received an invitation to participate. Reasons for not participating: chose not to participate (63%), sleeping—staff reluctant to wake (25%), not English speaking (7%), breastfeeding (5%). Conclusion Implementation of a family participation bundle was successful in increasing invitations to parents to participate during morning rounds in the CTICU. Engagement of staff and addressing specific staff concerns was instrumental in the project’s success.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 49%

mentioning

confidence: 99%

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Increasing Parental Participation During Rounds in a Pediatric Cardiac Intensive Care Unit

Blankenship

Harrison

Brandt

et al. 2015

American Journal of Critical Care

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“…36 | VOLUME 16 and is consistent with a study of work rounds on a general internal medicine unit. 23 However, the range of our recorded rounding times is striking.…”

Section: An Official Journal Of the American Academy Of Pediatricssupporting

confidence: 60%

A Time-Motion Study of Inpatient Rounds Using a Family-Centered Rounds Model

Bhansali

Birch

Campbell

et al. 2013

Hospital Pediatrics

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OBJECTIVE:Family-centered rounds (FCR) have become increasingly prevalent in pediatric hospital settings. The objective of our study was to describe time use and discrete events during pediatric inpatient rounds by using a FCR model. METHODS:We conducted a prospective observational study at Children's National Medical Center between September 2010 and February 2011. Investigators directly observed rounds on hospitalist and neurology services. Events were timed, and key features were recorded by using a Microsoft Access-based program. Associations with increased time spent during rounds were determined by using regression analyses. RESULTS:One hundred fi fty-nine rounding encounters were observed. Rounds lasted 7.9 minutes on average per patient. An average of 1.3 minutes was spent between patients during rounds. Eighty-six (54%) encounters occurred outside the patient's room, 3% of the time because of the family's request. Infectious isolation was associated with rounds occurring outside the room (P < .0001). Participation of the parent, location of rounds inside or outside the patient's room, most teaching behaviors, and interruptions were not signifi cantly associated with increased time spent during rounds. Teaching physical examination techniques by allowing multiple trainees to examine the patient was associated with increased rounding time (P = .02). CONCLUSIONS:The majority of rounds occurred outside the patient's room, yet rarely at the parent's request. Patients on infectious isolation were more likely to have rounds occur outside the patient's room. Neither parental participation nor most teaching behaviors were associated with increased time spent on rounds. These fi ndings will enrich the evidence base needed to establish FCR best practices.

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“…There are also concerns that rounds may not be the best avenue to convey information and solicit family input in decision making. Conversely, there is a fear that the presence of parents might inhibit open discussion among staff [51,52].…”

Section: Family-centered Carementioning

confidence: 91%

Forgoing Life-Sustaining or Death-Prolonging Therapy in the Pediatric ICU

Devictor

Latour

Tissières

2008

Pediatric Clinics of North America

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Assessment of parental presence during bedside pediatric intensive care unit rounds: Effect on duration, teaching, and privacy*

Abstract: Parental presence on rounds does not seem to interfere with the educational and communication process. Parents report satisfaction with participation in rounds, and privacy violations do not seem to be a concern from their perspective.

Cited by 83 publications

References 13 publications

Increasing Parental Participation During Rounds in a Pediatric Cardiac Intensive Care Unit

Increasing Parental Participation During Rounds in a Pediatric Cardiac Intensive Care Unit

A Time-Motion Study of Inpatient Rounds Using a Family-Centered Rounds Model

Forgoing Life-Sustaining or Death-Prolonging Therapy in the Pediatric ICU

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