ABSTRACT
Animal-assisted therapies are an innovative strategy within health care humanization initiatives, and they could play a role in the reduction of pain or anxiety. The main objective of this work was to evaluate the feasibility of implementing animal-assisted therapy in a pediatric intensive care unit and its effectiveness for the reduction of pain, fear, and anxiety. A prospective, quasi-experimental study of animal-assisted therapy was designed in the pediatric intensive care unit of the Hospital Universitario 12 de Octubre of Madrid, from January 2019 to December 2019. The study sample included patients who had been admitted to the unit and were over 3 years old. Satisfaction surveys were collected from the patients, family, and health personnel involved. Physiological variables and the level of pain (visual analog scale or Wong-Baker scale), fear (Child Medical Fear Scale), and anxiety (modified Yale Preoperatory Anxiety Scale) were evaluated before and after each session. Any existence of adverse events was recorded. A total of 74 therapy sessions were performed on 61 patients. All sessions were completed without any adverse effects. A total of 164 surveys were collected, providing an overall project rating of 9.69 out of a possible 10. The survey comments were found to be positive in most cases. No differences were found in the physiological variables measured before and after each session. There was a statistically significant decrease in pain, fear, and anxiety levels (p < 0.01). Conclusion: The implementation of an animal-assisted therapy project in a pediatric intensive care unit is feasible and safe and has a high degree of acceptance among both participants and healthcare staff. Animal-assisted therapy is effective for the reduction of pain, fear, and anxiety, and therefore, it could be considered an adjunct to non-pharmacological therapy. What is Known: ⢠Animal assisted therapies (AAT) are an innovative strategy that could be beneficial to help pediatrics patients cope with admission difficulties and could even play a role in reducing pain, anxiety and/or delirium. ⢠To date there are not studies to analyze the effectiveness of AAT in the field of Pediatric Intesive Care. What is New: ⢠Our study confirms the feasibility and effectiveness of the implementation of an AAT in the field of Pediatric Intensive Care with a high degree of acceptance by participants, caregivers and healthcare personnel. ⢠AAT demonstrated a reduction in pain, fear and anxiety in pediatrics patients admitted to Pediatric Intensive Care Unit.
Subject(s)
Animal Assisted Therapy , Animals , Humans , Child , Child, Preschool , Prospective Studies , Feasibility Studies , Anxiety/therapy , Fear , Intensive Care Units, Pediatric , PainABSTRACT
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition.
Subject(s)
Intensive Care Units, Pediatric/standards , Patient Admission/standards , Patient Discharge/standards , Triage/standards , Child , Humans , SpainABSTRACT
La unidad de cuidados intensivos pediátricos (UCIP) es una unidad física asistencial hospitalaria independiente especialmente diseñada para el tratamiento de pacientes pediátricos quienes debido su gravedad o condiciones potencialmente letales requieren observación y asistencia médica intensiva integral y continua por un equipo médico que haya obtenido competencia especial en medicina intensiva pediátrica. La aplicación oportuna de terapia intensiva a los pacientes críticos reduce la mortalidad, el tiempo de estancia y los costes asistenciales. Con los objetivos de respetar el derecho del niño al disfrute del más alto nivel posible de salud y a servicios para el tratamiento de las enfermedades y la rehabilitación de la salud y de garantizar la calidad asistencial y la seguridad de los pacientes pediátricos críticos, la Asociación Española de Pediatría (AEP), la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) han desarrollado y aprobado las guías de ingreso, alta y triage para las UCIP en España. Mediante la aplicación de estas guías se puede optimizar el uso de las UCIP españolas de forma que los pacientes pediátricos reciban el nivel de cuidados médicos más apropiado para su situación clínica
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition
Subject(s)
Humans , Child , Patient Admission , Patient Discharge/standards , Triage/standards , Intensive Care Units/standards , Critical Care , Patient Safety , SpainABSTRACT
La unidad de cuidados intensivos pediátricos (UCIP) es una unidad física asistencial hospitalaria independiente especialmente diseñada para el tratamiento de pacientes pediátricos quienes debido su gravedad o condiciones potencialmente letales requieren observación y asistencia médica intensiva integral y continua por un equipo médico que haya obtenido competencia especial en medicina intensiva pediátrica. La aplicación oportuna de terapia intensiva a los pacientes críticos reduce la mortalidad, el tiempo de estancia y los costes asistenciales. Con los objetivos de respetar el derecho del niño al disfrute del más alto nivel posible de salud y a servicios para el tratamiento de las enfermedades y la rehabilitación de la salud y de garantizar la calidad asistencial y la seguridad de los pacientes pediátricos críticos, la Asociación Española de Pediatría (AEP), la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) han desarrollado y aprobado las guías de ingreso, alta y triage para las UCIP en España. Mediante la aplicación de estas guías se puede optimizar el uso de las UCIP españolas de forma que los pacientes pediátricos reciban el nivel de cuidados médicos más apropiado para su situación clínica
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous intensive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition
Subject(s)
Humans , Child , Intensive Care Units, Pediatric/organization & administration , Triage/methods , Patient Discharge Summaries/standards , Admitting Department, Hospital/organization & administration , Hospitalization/trends , Critical Care/methods , Quality of Health Care/trends , Patient SafetyABSTRACT
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition.
Subject(s)
Intensive Care Units, Pediatric/organization & administration , Patient Admission/standards , Patient Discharge/standards , Triage/standards , Child , Clinical Decision-Making , Diagnosis-Related Groups , Guideline Adherence , Humans , Intensive Care Units, Pediatric/statistics & numerical data , Organizational Policy , Patient Handoff/standards , SpainABSTRACT
Fundamento: En la última década, se aprecia un creciente interés por los aspectos más humanos de la enfermedad que se traduce en un acercamiento a la familia y a su sufrimiento. Objetivo: Conocer en profundidad la experiencia de los profesionales y de los padres de niños ingresados en la unidad de cuidados intensivos pediátricos (UCIP). Material y métodos: Se organizaron grupos focales (GF) de padres de hijos fallecidos o con secuelas graves ingresados en la UCIP los años 1999-2002. Asimismo, se desarrollaron reuniones de GF de profesionales. Se revisó desde el ingreso hasta la muerte y el seguimiento del duelo. Se recogieron las inquietudes y las necesidades expresadas por el personal sanitario. Resultados: Se contactó con 133 familias (40% de hijos fallecidos y 60% de hijos con secuelas), de los que acudieron un 75% y un 44%, respectivamente. Las madres acudieron más (61%) en el caso de fallecidos, y las parejas (51%), en el caso de niños con secuelas. Asimismo, se organizaron GF con 22 personas (5 médicos, 11 enfermeras y 5 auxiliares de enfermería). Se recogieron los principales problemas, discrepancias y soluciones. Se instauraron medidas de mejora acordes con la información recibida. Conclusiones: La aplicación de GF ha permitido el acercamiento a las necesidades y problemas más importantes de los padres de niños que ingresan en la UCIP, así como de los profesionales. Esta información ha facilitado la implantación de medidas de mejora de una forma realista y ajustada a estas necesidades
Background: In the last 10 years, there has been increasing concern for a more human approach to illness, which has led to a better understanding of families and their suffering. Objective: To gain greater insight into the experience of the parents of children admitted to the PICU and of the health workers in these units. Material and methods: Focus groups (FG) composed of parents with children who had died or who were having serious sequels were organized in the PICU from 1999-2002. Likewise, FG meetings with health professionals were set up. The period from admission to death and support for grieving families were reviewed. At the same time, the concerns and needs mentioned by health professionals were collected. Results: A total of 133 families were contacted by surface mail (40% had children who had died and 60% had children with sequels who survived); of these, 75% of the families in the first group and 44% of those in the second group attended the FG. Attendance by mothers (61%) was more frequent in the case of death, and attendance by couples (51%) was more frequent in children with sequels. Focus groups were organized with 22 health professionals (five physicians, 11 nurses and five nurses' aids). The main problems, discrepancies and solutions identified by the distinct groups were recorded. Improvement measures were implemented according to the available information. Conclusions: The use of FG allowed us to approach to the most important needs and problems of parents with children admitted to the PICU, as well as those of the heath workers in the unit. This information allowed improvement measures adjusted to these needs to be implemented in a realistic manner
