A Pediatric Intensive Care Checklist for Interprofessional Rounds: The R-PICniC Study.

BACKGROUND: The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety. OBJECTIVES: To build and validate a checklist for use in interprofessional rounds in a pediatric intensive care unit. METHODS: This methodological study was conducted in a 20-bed pediatric intensive care unit serving children up to 14 years old. A checklist prototype was constructed through review of the literature and achievement of consensus among the professionals providing care in the unit. Content validation was performed using a modified Delphi technique involving specialists with more than 5 years of experience in pediatric intensive care, methodological studies, and patient safety. Content validity ratios were calculated for the elements of the checklist, which were considered valid when they reached values greater than 0.78. The checklist was tested for usability, application time, and effects on patient care, and feedback was obtained from potential users. RESULTS: Before content validation, the checklist contained 11 domains, 32 items, and 6 daily goals. The invitation to validate content was sent to 86 specialists, and content validity was achieved after 2 rounds of evaluation, with the checklist elements having content validity ratios ranging from 0.94 to 0.97. The mean application time of the checklist was 5 minutes. The final version consisted of 11 domains, 33 items, and 8 daily goals. CONCLUSIONS: This study resulted in a useful and valid instrument for application in interprofessional rounds that was tailored to the needs of local health care professionals.

Effectiveness of checklists in multidisciplinary rounds for improving patient safety in the pediatric intensive care unit: a systematic review protocol.

OBJECTIVE: This review will evaluate the effectiveness of checklist use in multidisciplinary rounds, compared with multidisciplinary rounds without checklists, for improving mortality and patient safety in the pediatric intensive care unit. INTRODUCTION: Single studies have demonstrated that checklists can potentially improve communication of care between health professionals, reduce adverse events, and increase adherence to best practice guidelines. However, no systematic review of the literature has explored the use of checklists in the pediatric intensive care unit. INCLUSION CRITERIA: This review will consider studies that include pediatric patients, under 18 years of age, admitted to a pediatric intensive care unit. Identified studies will compare the use of checklists in multidisciplinary rounds with multidisciplinary rounds with no checklists. The studies will also evaluate mortality and patient safety outcomes. We will consider experimental and observational studies, published in any language, with no date restrictions. METHODS: The search strategy will aim to locate both published and unpublished studies. Databases to be searched include MEDLINE, the Cochrane Library, Web of Science, LILACS, Scopus, Embase, CINAHL, the Center for Reviews and Dissemination, Database of Abstracts of Reviews of Effects, and Epistemonikos. The studies will be screened and those meeting the inclusion criteria will be retained by two independent researchers. Assessment of methodology and data extraction will then be carried out. The data will be presented using a narrative synthesis and the studies will be pooled with a statistical meta-analysis, where possible. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021233798.

Nursing practice environment, job outcomes and safety climate: a structural equation modelling analysis.

AIM: To assess correlations between the characteristics of the nursing practice environment, job outcomes and safety climate. BACKGROUND: The nursing practice environment is critical to the well-being of professionals and to patient safety, as highlighted by national and international studies; however, there is a lack of evidence regarding this theme in paediatric units. METHODS: A cross-sectional study, in two paediatric hospitals in Brazil, was conducted from December 2013 to February 2014. For data collection, we used the Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and the Maslach Burnout Inventory, and for analysis Spearman's correlation coefficient and structural equation modelling were used. RESULTS: Two hundred and sixty-seven professional nurses participated in the study. Autonomy, control over the work environment and the relationship between nursing and medical staff are factors associated with job outcomes and safety climate and can be considered their predictors. CONCLUSIONS: Professional nurses with greater autonomy, good working relationships and control over their work environment have lower levels of emotional exhaustion, higher job satisfaction, less intention of leaving the job and the safety climate is positive. IMPLICATIONS FOR NURSING MANAGEMENT: Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses.

Stress related to care: the impact of childhood cancer on the lives of parents.

OBJECTIVES: The objective was to assess the stress levels of parents of children with cancer and to identify correlations among demographic data and anxiety levels. METHODS: A descriptive, cross-sectional study, conducted in two Brazilian institutions, with 101 parents of children with cancer. Through interviews, parents responded to two instruments: Pediatric Inventory for Parents - Brazilian version, which assesses stress levels, and State-Trait Anxiety Inventory, for the measurement of anxiety. The correlations between the instruments and the sociodemographic variables of the parents and children were evaluated using the Spearman correlation coefficient. RESULTS: Higher levels of stress and anxiety were seen by young parents, young children and with less time since diagnosis. The fear of death and the disease impact on the life of a child were the events considered the most stressful for the parents . CONCLUSIONS: In clinical practice, the nurse who can identify the occurrence of these symptoms becomes capable of planning nursing care that includes the family in decisions about the care. Moreover, she can provide support to help parents manage their stress levels and positively face the illness of their children.