What we are doing?
A sequential mixed methods study design will be used. Implementation science will be used to create a strong base of evidence to enable PICUs in the UK to successfully adopt the ICU liberation bundle. This will then be tested in a single centre study.
Why we are doing it?
An admission to PICU can be stressful and traumatic, with the child likely to experience some of the following: painful procedures, disruption of normal sleep patterns, withdrawal and/or delirium and both child and family at risk of experiencing PTSD. The ICU liberation bundle of care has been developed to address this, with evidence showing that it can reduce the time spent mechanically ventilated, reduce pain, withdrawal and delirium and improve patient mobility. However, there is limited evidence of its use outside of North America meaning it is unclear how effective or sustainable the intervention would be in a different PICU setting.
What the benefits will be and to whom?
Successful implementation of the ICU liberation bundle has the potential to provide multiple benefits, as listed above, to children and their families that are impacted by a PICU admission. For staff working in the PICU, it has also been shown to improve staff teamwork, improve multi-disciplinary communication and guide better coordination of care. Furthermore, the implementation science perspective used may benefit the implementation of other evidence based interventions in the PICU.
Who we are working with?
Close liaison with the PCCU team at Nottingham Childrens Hospital, in particular a multi-disciplinary stakeholder group with interest in the ICU liberation bundle. Plan to bring in family stakeholders to provide PPI feedback throughout this study.
Elizabeth Dodds, Junior Sister, Paediatric Critical Care Unit, Nottingham Childrens Hospital NUH, PhD student, School of Health Sciences, University of Nottingham, Ntxed7@nottingham.ac.uk.