Current provision and perceptions of paediatric intensive care unit follow-up services: A binational organisational and clinician survey

Abstract

OBJECTIVES: The aim of this study was to (i) evaluate follow-up services in Australia and New Zealand for children surviving paediatric intensive care; (ii) assess clinician and service-wide knowledge of post-intensive care syndrome-paediatrics; and (iii) identify barriers to long-term follow-up services post paediatric intensive care unit admission. METHODS: Two cross-sectional, web-based REDCap surveys were designed for organisational leadership and individual clinician respondents. All paediatric intensive care units with staffed paediatric beds in Australia and New Zealand were invited to participate. RESULTS: Eleven paediatric intensive care units and 345 clinicians responded to the two surveys. None of the 11 paediatric intensive care units reported having any dedicated outpatient follow-up services. Only 53% of clinicians had heard of the term post-intensive care syndrome-paediatrics prior to the survey. However, most clinicians believed that follow-up care should be provided to children following a paediatric intensive care unit admission (96%) via a combination of modalities (49%) (e.g., telehealth and face-to-face) conducted by a multidisciplinary team (32%). Both the individual clinicians and the organisational leadership respondents identified staffing and budget restraints as the biggest barriers to follow-up care. CONCLUSIONS: Despite growing international evidence to support the implementation of paediatric intensive care unit follow-up services, Australian and New Zealand paediatric intensive care units do not currently offer such services. In implementing paediatric intensive care unit follow-up practices, staffing and budgetary restraints need to be addressed. Improving clinician- and organisation-wide awareness and understanding of post-intensive care syndrome-paediatrics and its impacts may also help to reduce barriers to implementing follow-up services in Australian and New Zealand paediatric intensive care units.