Patient and Family Comfort with Discharge Directly Home from the Pediatric Intensive Care Unit

ABSTRACT

BACKGROUND AND AIM: Children are increasingly being dischared directly home from the pediatric intensive care unit (PICU). Transitions out of critical care have been recognized as a period of increased patient and caregiver stress, as well as increased risk for adverse events. In children, there is little evidence evaluating patient/caregiver outcomes after being discharged directly home from the PICU. The aim of this study is to explore families experience with discharge directly home from the PICU. METHOD(S) This prospective mixed methods study was conducted in the PICU of CHU Sainte-Justine from January to July 2021. We included families of children expected to be discharged home in the following 12 hours. Qualitative data was obtained through semi-structured discharge interviews, then with telephone interviews 7 and 28 days post-PICU discharge. We measured comfort on a Likert scale, and screened for caregiver anxiety. RESULT(S) The families of 25 patients were interviewed. Median patient age was 1.5 years (0.6-8.6), and median length of stay was 3 days (IQR 2-4). Thematic analysis of the interviews on discharge day revealed several themes, such as feeling stress and anxiety, feeling confident, avoiding Covid-19, anticipating family and friends, knowing when to consult a physician and being supported by social media. Median comfort level on a 5-point Likert was 4 (comfortable) (IQR 4-5). CONCLUSION(S) Despite feelings of anxiety, many families felt comfortable with discharge directly home from the PICU. Increasing our understanding of the family experience of discharge from the PICU, will help to better support these patients/families during their transition from PICU to home.