Inpatient Unit Leaders' Perspectives on Parent Engagement in Neonatal and Pediatric Intensive Care: A Secondary, Qualitative Analysis.
Inpatient Unit Leaders' Perspectives on Parent Engagement in Neonatal and Pediatric Intensive Care: A Secondary, Qualitative Analysis.
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DOI：
10.1097/anc.0000000000000736
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发表时间：
2021-02-01
期刊：
影响因子：
--
通讯作者：
Brandon DH
中科院分区：
文献类型：
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作者：
Vance AJ;Docherty S;Brandon DH
医院单位领导帮助确定单位的优先事项，并负责指导单位的使命和护理理念；然而，领导人在促进重症监护病房内家长参与方面的观点有限。这项研究的目的是探索医疗和护理单位的领导如何在重症监护环境中促进父母的参与。对16名单位领导(医务主任和护士经理)的半结构化访谈进行了二次定性分析。定向内容分析使用系统的策略来探索访谈中的主题，以确保严谨。单位领导描述了支持父母参与所必需的护理提供的3个主要特征：(1)护理文化，(2)护理中的关系，以及(3)护理环境。提供者和父母之间的沟通和决策的时机是解决的关键领域，以及对物理空间限制父母参与的担忧。单位领导讨论了护理服务的三个主要特征(单位文化、人际关系和物理空间)是如何相互关联的，以优化父母的参与度。总体而言，单位领导认识到提供护理的每个特点在促进参与方面的重要性。家长参与度最终受到提供包容性护理的优化：物理空间、围绕医疗和护理的政策以及单位的整体文化的影响。未来的研究需要探索关于建立关系和管理空间限制的最佳实践。需要进一步澄清父母和提供者围绕父母在重症监护环境中的参与的需求和期望。
Hospital unit leaders help set the unit’s priorities and are responsible for guiding the unit mission and philosophy of care; however, the perspective of leaders in facilitating parent engagement within intensive care units is limited. The purpose of this study was to explore how medical and nursing unit leaders facilitate parent engagement in intensive care settings. Qualitative secondary analysis of 16 semistructured interviews of unit leadership (medical directors and nurse managers). Directed content analysis explored themes within the interviews using systematic strategies to ensure rigor. Unit leadership described 3 main features of care delivery necessary for supporting parent engagement: (1) culture of care, (2) relationships in care, and (3) environment of care. Communication among providers and parents and timing of decision-making were key areas addressed, along with concerns about physical space limiting parent engagement. Unit leaders discussed how the 3 main features (unit culture, relationships, and physical space) of care delivery were interconnected to optimize parent engagement. Overall, unit leaders recognized the importance of each feature of care delivery in facilitating engagement. Parent engagement is ultimately influenced by the optimization of delivering inclusive care: the physical space, the policies surrounding medical and nursing care, and the overall culture of the unit. Future research needs to explore best practices around relationship building and managing space limitations. Further clarification of the needs and expectations of both parents and providers surrounding parent engagement in intensive care settings is needed.