The Evolution of Pediatric Critical Care Nursing: Past, Present, and Future

Parent perceptions of the impact of the Paediatric Intensive Care environment on delivery of family-centred care

“…This necessitated family-centered partnerships with hospital staff, specifically nurses and physicians. While the care of children hospitalized in acute settings in the United States has made strides in the transition to a more familycentered model, PICUs have been slower to adopt this method of care delivery (Butler et al, 2013;Foglia and Milonovich, 2011), perhaps due to their use of technology, the critical conditions of their patients, and the history of limited visitation and participation by parents. Generally speaking, the PICU cultural environment can be characterized as having limited family visitation and/or involvement in direct care and decision making (Baird et al, 2015;Frazier et al, 2010;Kuo et al, 2012).…”

“…The PICU physical environment can be congested with life-saving equipment often minimizing the child patient in his or her hospital bed and leaving precious little free space at the bedside for parents or family members to participate. Since becoming a subspecialty in pediatric care in the 1960's (Foglia and Milonovich, 2011), PICU policies in the United States often limit parent visitation thereby contributing to a culture that has minimized the importance and value of parental presence at the bedside and parental involvement in decision making (Kuo et al, 2012). Parents and clinicians in the United States have expressed differing views on restricting visitation to specific daytime hours, and at shift changeover, medical rounding, and resuscitation events (Baird et al, 2015;Uhl et al, 2013), with parents favoring less restriction and clinicians favoring more.…”

Family-Centered Care From the Perspective of Parents of Children Cared for in a Pediatric Intensive Care Unit: An Integrative Review

“…Parents of children with chronic health conditions and key advocacy groups joined together to bring about change and prioritized FCC in the late-20 th century (Johnson, 1990). Slowly the care of hospitalized children has shifted to a more family-centered model; however the PICU has been slow to adopt these standards (Butler, Copnell, & Willetts, 2013; Foglia & Milonovich, 2011).…”

Family‐centred care in the paediatric intensive care unit: an integrative review of the literature

“…, Foglia & Milonovich ) as impediments to its practice. In the PICU environment, nurses are faced with increasing patient acuity, increasing demands on nursing resources and high patient and family needs, leading to activities that promote task‐oriented nursing care and unofficial closure of the PICU to the child's family (Foglia & Milonovich ). ‘Unofficial closure’ is the term given to discouragement of parental presence.…”

“…In the paediatric intensive care (PICU) environment, implementation of FCC has been identified as problematic. Commentators cite increased demands on the nurse for technical expertise, increased levels of involvement with technology and a specific nursing focus on the child (Tomlinson et al 2002, Foglia & Milonovich 2011 as impediments to its practice. In the PICU environment, nurses are faced with increasing patient acuity, increasing demands on nursing resources and high patient and family needs, leading to activities that promote task-oriented nursing care and unofficial closure of the PICU to the child's family (Foglia & Milonovich 2011).…”