Exploring the impact of the COVID‐19 environment on nursing delivery of family‐centred care in a paediatric hospital

Abstract

Aims and objectives:To understand how the pandemic environment impacted the delivery of FCC of children and families from a nursing perspective in a major tertiary paediatric hospital.Background: Family-centred care (FCC) is a well-established framework to promote parental involvement in every aspect of a child's hospitalization, however, rules and restrictions in place during the COVID-19 pandemic affected the ways in which Family-centred Care could be delivered in practice.Design: This is a qualitative exploratory descriptive study to elicit the perspective of paediatric nurses delivering care to children in a hospital during the COVID-19 pandemic in Victoria, Australia. Methods:Nurses from all subspecialties in a tertiary paediatric hospital were invited to participate in virtual focus groups to discuss their experience of delivering FCC during the COVID-19 pandemic. Focus groups were recorded and transcribed, then analysed using Framework Analysis. Results: Nineteen nurses participated across seven focus groups during June and July 2020. The four themes-Advocating with empathy, Enabling communication, Responding with flexibility, and Balancing competing considerations-and the eight subthemes that were generated, outline how nurses deliver FCC, and how these FCC actions were impacted by the COVID-19 environment and the related hospital restrictions. Conclusion: This study documents the experiences, resilience and resourcefulness of paediatric nurses in Australia during the COVID-19 pandemic as well as moving Family-centred Care from a theoretical framework into a practical reality. Impact: The findings from this study should inform consideration of the impacts of public health policies during infectious disease outbreaks moving forward. In addition by describing the core actions of Family-centred Care, this study has implications for educational interventions on how to translate FCC theory into practice.No public or patient contribution as this study explored nursing perceptions only.

Our New Normal: Pediatric Nurse Residents’ Experiences with Transition to Practice during the COVID-19 Pandemic

“…The final theme, Shattered Family-Centered Care, underscored the disruption to traditional patient-and-family care paradigms, a hallmark of pediatrics and pediatric nursing. This had a profound, distressing effect on pediatric care providers and nurses caring for children in hospital settings [ 66 ]. Nurse residents in the current study reflected on the negative consequences of visitation restrictions on their patients and their families.…”

“…In pediatric nurses, pandemic-era research mirrored concerns expressed by the general nursing workforce. However, the pediatric nurse experience revealed additional considerations related to family-centered care, restrictions in (parent and family) visitation, pediatric nurses’ fear, and difficulty transitioning to care for adult patients with COVID-19 [ 65 , 66 , 67 ]. The disruption of family-centered care directly resulted from visiting restrictions on parents, siblings, friends, and extended family members [ 68 , 69 , 70 , 71 ].…”

“…The disruption of family-centered care directly resulted from visiting restrictions on parents, siblings, friends, and extended family members [ 68 , 69 , 70 , 71 ]. The inability of family units to stay together led to missed child “firsts” [ 66 ] and likely affected child well-being. In the neonatal population, the inability to keep the family unit together and the separation of newborns from their mothers and fathers altered breastfeeding and parental bonding [ 72 ].…”

Need to reduce anxiety and obtain individualised information are considered the main supportive components of parents/caregivers of children with cancer through the COVID-19 pandemic in the UK

“…The concept of care by nurses takes centre stage when there is no precise therapy for a health crisis 3. Family-centred care is advocated as a way for nurses to better handle the needs of children and families during the COVID-19 epidemic by taking into account factors including allowing communication, advocating with empathy, responding with flexibility and balancing competing considerations 4. During challenging times, nurses’ spiritual intelligence must be strengthened to give hope and meaning to children with cancer and their families.…”