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Published online September 7, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. 1119-1125 (doi:10.1542/peds.2009-0369)
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ARTICLE

Impact of Family Presence During Pediatric Intensive Care Unit Rounds on the Family and Medical Team

Paul L. Aronson, MDa,b, Jennifer Yau, MBSc, Mark A. Helfaer, MDc,d, Wynne Morrison, MDc,d

Departments of a Pediatrics
c Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Departments of b Pediatrics
d Anesthesiology and Critical Care Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

OBJECTIVES: Our objectives were to determine the impact of family presence during PICU rounds on family satisfaction, resident teaching, and length of rounds and to assess factors associated with family satisfaction.

METHODS: This was an observational study of a convenience sample of morning work rounds in a PICU, followed by surveys of family members of patients in the unit and residents who had been present for rounds.

RESULTS: A total of 411 patient encounters were observed, 98 family questionnaires were fully completed, and 33 resident questionnaires were completed. Ninety-eight percent of family members liked to be present for rounds. On the first day of admission, family members were less likely to understand the plan (P = .03), to feel comfortable asking questions (P = .007), or to want bad news during rounds (P = .009). They were more likely to have privacy concerns (P = .02) and to want 1 individual to convey the plan after rounds (P = .01). Higher education level was associated with decreased privacy concerns (P = .002) but did not affect understanding of the plan. Fifty-two percent of residents perceived that teaching was decreased with families present. Time spent with individual patients was not increased by family member presence (P = .12).

CONCLUSIONS: Family satisfaction is high, but families of patients on the first day of admission may need special attention. The medical team should conduct rounds in a manner that addresses the privacy concerns of families. Residents often think that teaching is decreased when families are present.

Key Words: family-centered • bedside rounds • parental satisfaction • teaching satisfaction

Abbreviations: PRISM—Pediatric Risk of Mortality • OR—odds ratio • CI—confidence interval

Accepted May 28, 2009.


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