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E u r o S c i C o n C o n f e r e n c e o n
PEDIATRICS
2017
Pediatrics 2017
Volume:3 Issue:4(Suppl)
Journal of Pediatric Care
ISSN 2471-805X
N o v e m b e r 1 3 - 1 4 , 2 0 1 7
L o n d o n , U K
Page 13
I
mproving the Patient and family experience in the Pediatric Critical Care
Environment. Unlike adults, critically ill children usually do not have an
advanced directives, and thus their parents act as surrogate decision
makers. Care collaboration between the care providers and the surrogate
decision makers make the Critical Care Unit a challenging environment with
many unfamiliar personnel and environment. The care team must stabilize
the patient, which introduces a number of invasive interventions: intubation
of the airway, the passage of tubes into the stomach, placement of vascular
access devices, and the use of other complex devices. We propose strategies
designed to improve the patient/family’s experience. Communication between
the parents and the critical care team includes: visible presence on daily
rounds, periodic multi-disciplinary care conferences, the use the palliative
care team and the institutional Ethics Committee. Daily rounds provide the
opportunity for the family to be part of the ICU care team and better understand
their child’s care plan. When the patient’s ICU stay is prolonged, the family and
the care team benefit from a multi-disciplinary care conferences that include
the medical and surgical consultants, the bedside personnel, and ancillary
staff. This may identify additional support needed. If the patient’s stay is
extended, a Palliative Care consult may be helpful for both the family and staff
in readdressing various goals of care. They may assist in the very difficult
discussions regarding Code status, limiting further unnecessary interventions,
reducing support, providing comfort care for the child and the family, and
possibly creating a more dignified environment for the ongoing care needs.
If the care is not perceived to be in sync with the medical providers and the
family, an Ethics Consult may assist in getting the everyone to move in the
same direction regarding the child’s continued medical support. In summary,
the PICU can be a very difficult environment for all those involved in the care of
the critically ill pediatric patient. The PICU should be provide a comprehensive
coordinated care plan for the patient that insures respect for patient and family
autonomy, is supportive of the staff caring for the child, and utilizes numerous
resources available.
Biography
Lorry Frankel, completed his MD in 1978 from the University of
Antwerp, Belgium. He then trained in Pediatrics and Pediatric
Critical Care Medicine finishing his training in 1983. He was
then hired by Stanford University in the School of Medicine
(Department of Pediatrics) to develop the Pediatric ICU. He
was promoted to professor and retired from Stanford in 2010
to assume the current role as the Chair of the Department of
Pediatrics at the California Pacific Medical Center in San Fran-
cisco, a Sutter Health Care Affiliate. During his career he has
published more than 40 Peer reviewed papers, numerous chap-
ters and co-authored a book on Ethical Dilemmas in Pediatrics
published in 2006
frankeL@sutterhealth.orgHow to improve the patient and family experience
in the pediatric critical care environment
Lorry R Frankel
1,2
1
Stanford University School of Medicine, USA
2
California Pacific Medical Center - Sutter Health, USA
Lorry R Frankel, J Pediatr Care 2017, 3:4(Suppl)
DOI: 10.21767/2471-805X-C1-002