Purpose: In the UK, critically ill adolescents are treated in either adult or paediatric intensive care units (AICUs or PICUs). This study explores staff perspectives on where and how best to care for this distinct group.
Materials and Methods:Semi-structured interviews were conducted with 12 members of staff (3 medical, 6 nursing and 3 allied-health professionals) working in 4 ICUs; 2 general hospital AICUs and 2 tertiary centre-based PICUs in England. Interviews were audio-recorded, transcribed and analysed using Framework Analysis.Findings: One overarching theme was identified, reflecting staff understanding of the term "adolescent", and this was linked to two further themes, each of which had several subthemes. "Needs of the critically ill adolescent" included medical needs, dignity and privacy; issues around consent; and the impact of intensive care admission."Implications for staff" included managing parental presence, and lack of familiarity with, and emotional impact of, dealing with this patient group. Some of these factors are currently better accommodated in adult settings.
Conclusions:Decision-making about place of care should take into account the individual circumstances of the patient (e.g. nature of their medical condition and previous experiences, maturity, family preference) and not be based only on age at admission. We should work across disciplines to ensure we can discover, and consistently deliver, best practice to meet the needs of critically ill adolescents.