Toward the inclusion of parents on pediatric critical care unit rounds

Background: Inclusion of parents on interprofessional patient rounds is increasingly recognized as a parental right and as a marker of quality care in pediatric intensive care units. Creating policies and practices that welcome parents and their contributions into patient rounds has proven challenging in many settings. Objective: To develop a detailed understanding of the physical, professional and interpersonal contexts of one pediatric intensive care unit in order to develop a feasible, relevant and sustainable approach to parental inclusion on rounds. Design: Prospective qualitative and descriptive exploratory survey. Setting: A pediatric Intensive care unit at a tertiary care children's hospital. Subjects: Physicians, nurses and other health care professionals working in our pediatric intensive care unit and to all parents who had children admitted to the unit during a one month period. Interventions: None. Measurement and Main Results: Surveys were distributed to physicians, nurses and other health care professionals working in our pediatric intensive care unit and to all parents who had children admitted to the unit during a 1-month period. In addition in-depth interviews were conducted with a subset of 13 healthcare providers. Descriptive statistics were used to report survey results. Transcripts of the interviews and the qualitative comments provided on the surveys were analyzed according to principles of interpretive description. Parents indicated a strong desire to participate in pediatric intensive care unit rounds, while healthcare providers varied in the extent to which they believed parents' participation would achieve the intended goals. Key considerations that need to be addressed for successful practice change to incorporate parents on rounds include: working on consistent and reliable communication, addressing the issues of confidentiality, time constraints, and teaching during rounds, and attention to the role of parents during rounds and health care professionals' facilitation of that role. Conclusion: The participants in this study believed that parents' participation on rounds is an important consideration. For inclusion of parents to be effective and sustainable, policy and practice change in this direction requires measures to recognize parents as important contributors to pediatric intensive care unit rounds while accounting for the complex responsibility of healthcare providers in the physical and social space of the pediatric intensive care unit. (Pediatr Crit Care Med 2011; 12:e255-e261)