Pediatric Critical Care Nursing Research Priorities in Asia: An eDelphi Study*

Poh, Pei-Fen; Sng, Qian Wen; Latour, Jos M.; He, Li-Xian; Fong, Mei Fung; Muralidharah, Jayashree; Abbas, Qalab; Matsuishi, Yujiro; Lee, Jan Hau

doi:10.1097/pcc.0000000000003023

Cited by 4 publications

(13 citation statements)

References 40 publications

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“…Perhaps not surprisingly, inhalation injury and percentage of total body surface area (TBSA) burned on the trunk and head/neck were independently associated with the duration of IMV in burned children in this study, similar to prior reports indicating worse outcomes associated with these factors (2)(3)(4)(5)(6). The association of younger age and female gender with more prolonged IMV may be surprising to the reader, but some limited prior data exist.…”

supporting

confidence: 81%

“…The association of younger age and female gender with more prolonged IMV may be surprising to the reader, but some limited prior data exist. Younger age has previously been described as a risk factor for needing IMV in scald burn (3)…”

mentioning

confidence: 96%

“…Interestingly, both parents and PICU HCPs prioritized workforce-related issues, such as preventing burnout. Like Poh et al (3), in the top 10 priorities for both HCP and families was decision-making around EoL care in PICU.…”

mentioning

confidence: 99%

“…Nursing interventions in EoL care was again a top priority question. Importantly, the study by Poh et al (3) was the first to conclude that longer term outcomes of children and families should be prioritized in research. The most recent study, conducted in the United Kingdom in 2018 (7), included PICU nurses, all PICU HCPs, and the views of parents and families.…”

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confidence: 99%

“…A limitation recognized in many of these PICUresearch prioritization exercises is that patients, parents, and families have not been involved (3)(4)(5)(6). Although this can be challenging to do, just because it is difficult does not mean it should not be done, and we must ensure we know what children and families think is needed now and in the future.…”

mentioning

confidence: 99%

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Do Research Prioritization Exercises Reduce Research Waste?*

Tume¹

2022

Pediatric Critical Care Medicine

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pediatric patients with RSE? Midazolam has been reported to be effective for the treatment of RSE in pediatric patients, and the retrospective nature of the study by Daniels et al (11) reaffirms this in routine clinical use, not just in the setting of prospective trials or meta-analyses. However, it is the single-center retrospective nature, lack of midazolam bolus dosing, and limited knowledge surrounding the administration of first-and second-line antiseizure therapies for many of the patients that limits the scope of impact regarding the author's quantitative results. There is still significant work to be done to define the following: 1) the best way to titrate midazolam to achieve the shortest time to seizure cessation, including knowing when to move on to another anesthetic agent; 2) determining the contribution of the total medication exposure to the diminished cognitive outcomes post SE; and 3) defining patient and disease-related risk factors for midazolam failure in RSE. Although the results presented by Daniels et al ( 11) may be limited in scope, the study provides important insight, both positive and negative, that will be crucial to consider in the design of a future multicenter trial assessing the most effective use of midazolam to treat pediatric RSE.

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supporting

confidence: 81%

mentioning

confidence: 96%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Do Research Prioritization Exercises Reduce Research Waste?*

Tume¹

2022

Pediatric Critical Care Medicine

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Parental emotional, social and transitional health in the first 6 months after childhood critical illness: A longitudinal qualitative study

Poh,

Carey,

Manning

et al. 2024

Journal of Advanced Nursing

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AimTo explore the experiences and support needs of parents in the first 6 months after paediatric critical care.DesignLongitudinal qualitative design.MethodsSequential semi‐structured qualitative interviews were conducted with a sample of 28 parents in succession at 1 month and at 6 months (n = 22) after their child's discharge from paediatric critical care using purposive sampling. Data were analysed using the adapted five‐stage framework analysis.ResultsData were developed into eight synthesized themes, three domains and an overarching theme: Regaining Normalcy. Families of children requiring medical treatment at 6 months showed signs of adaption to daily care routines. The two domains were Parental Emotional Health and Parental Social Health. Parental Transitional Health, a third domain, was added to the Post Intensive Care Syndrome‐paediatric framework. Parents were forward‐looking and discussed emotional health, relating to current caregiving issues. Emotional attention was related to present challenges and concerns about current health and possible readmission to the hospital. In terms of Parental Social Health, families isolated themselves for infection control while remaining connected with families using chat applications. Parents were selective to whom they allowed access to their lives. The impact of parental transitional health was evident and emphasized the daily challenges associated with integration back to home life. Flexible work arrangements allowed working parents to support caregiving needs in the first 6 months after discharge.ConclusionIn the first 6 months after paediatric critical illness, most families reported having moved past the experiences while having provoking memories of the admission period. Parents viewed the point of normalcy as child returned to school or when all medications were discontinued. Extension of transitional support can facilitate discharge experiences between paediatric critical care and normalcy. The findings highlight the importance of understanding the medium‐ and longer‐term impact of paediatric critical care.Impact What problem did the study address? Limited understanding of long‐term parental experiences and support needs after PICU discharge. What were the main findings? Most families regained normalcy when child returns to school or when medications were discontinued. Some families continued to show signs of adaptations at 6 months after PICU discharge. Where and on whom did the research have an impact? The research has an impact on improving the understanding of long‐term parental experiences and support needs after PICU discharge, informing clinical practice, guiding policy development and shaping parental support programs. Reporting MethodWe reported this study using the COREQ guidelines.Patient or Public ContributionPrior to confirming the interview guide, three parents of critically ill children actively participated by reviewing and providing feedback on its content. They provided suggestions to refine the wording and ensure clarity to enhance the participants' understanding. By including the perspectives of these parents, we aimed to improve the overall quality and relevance of the interview guide.

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Interventions to promote cost-effectiveness in adult intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study

Kansal,

Latour,

See

et al. 2023

Crit Care

Self Cite

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Background There is limited evidence to guide interventions that promote cost-effectiveness in adult intensive care units (ICU). The aim of this consensus statement is to identify globally applicable interventions for best ICU practice and provide guidance for judicious use of resources. Methods A three-round modified online Delphi process, using a web-based platform, sought consensus from 61 multidisciplinary ICU experts (physicians, nurses, allied health, administrators) from 21 countries. Round 1 was qualitative to ascertain opinions on cost-effectiveness criteria based on four key domains of high-value healthcare (foundational elements; infrastructure fundamentals; care delivery priorities; reliability and feedback). Round 2 was qualitative and quantitative, while round 3 was quantitative to reiterate and establish criteria. Both rounds 2 and 3 utilized a five-point Likert scale for voting. Consensus was considered when > 70% of the experts voted for a proposed intervention. Thereafter, the steering committee endorsed interventions that were identified as ‘critical’ by more than 50% of steering committee members. These interventions and experts’ comments were summarized as final considerations for best practice. Results At the conclusion of round 3, consensus was obtained on 50 best practice considerations for cost-effectiveness in adult ICU. Finally, the steering committee endorsed 9 ‘critical’ best practice considerations. This included adoption of a multidisciplinary ICU model of care, focus on staff training and competency assessment, ongoing quality audits, thus ensuring high quality of critical care services whether within or outside the four walls of ICUs, implementation of a dynamic staff roster, multidisciplinary approach to implementing end-of-life care, early mobilization and promoting international consensus efforts on the Green ICU concept. Conclusions This Delphi study with international experts resulted in 9 consensus statements and best practice considerations promoting cost-effectiveness in adult ICUs. Stakeholders (government bodies, professional societies) must lead the efforts to identify locally applicable specifics while working within these best practice considerations with the available resources.

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Pediatric Critical Care Nursing Research Priorities in Asia: An eDelphi Study*

Cited by 4 publications

References 40 publications

Do Research Prioritization Exercises Reduce Research Waste?*

Do Research Prioritization Exercises Reduce Research Waste?*

Parental emotional, social and transitional health in the first 6 months after childhood critical illness: A longitudinal qualitative study

Interventions to promote cost-effectiveness in adult intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study

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