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dc.contributor.authorGill, Fenella
dc.contributor.authorLeslie, Gavin
dc.contributor.authorMarshall, A.P.
dc.date.accessioned2020-07-17T05:53:05Z
dc.date.available2020-07-17T05:53:05Z
dc.date.issued2019
dc.identifier.citationGill, F.J. and Leslie, G.D. and Marshall, A.P. 2019. Parent escalation of care for the deteriorating child in hospital: A health-care improvement study. Health Expectations. 22 (5): pp. 1078-1088.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/80079
dc.identifier.doi10.1111/hex.12938
dc.description.abstract

Objective: To evaluate the implementation of an intervention for parents to escalate care if concerned about their child's clinical condition. Design: Mixed-methods health-care improvement approach guided by the Theoretical Domains Framework. Methods: Implementation of the ‘Calling for Help’ (C4H) intervention was informed by previously identified barriers and facilitators. Evaluation involved audit, review of clinical deterioration incidents, interviews and focus groups.

Setting: Australian specialist paediatric hospital. Participants: Convenience sample of 75 parents from inpatient areas during the audit, interviews with ten parents who had expressed concern about their child's clinical condition; five focus groups with 35 ward nurses.

Main outcome measures: Parent awareness and utilization of C4H, parent and nurse views of factors influencing implementation.

Results: Parent awareness of C4H improved to 35% (25/75). Parent concern was documented prior to 21/174 (12%) clinical deterioration events. All interviewed parents and nurses who participated in focus groups were positive about C4H. Parents preferred to be informed about C4H by nurses, but nurses described this as time-consuming and selectively chose parents who they believed would benefit most. Parents and nurses described frustrations with and trepidation in escalating care. Nurses had used C4H to expedite urgent medical review.

Conclusions: There was an improvement in the level of parent awareness of C4H, which was viewed positively by parents and nurses alike. To achieve a high level of parent awareness in a sustainable way, a multifaceted approach is required. Further strategies will be required for parents to feel confident enough to use C4H and to address interprofessional communication barriers.

dc.languageEnglish
dc.publisherWILEY
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectHealth Care Sciences & Services
dc.subjectHealth Policy & Services
dc.subjectPublic, Environmental & Occupational Health
dc.subjectclinical deterioration
dc.subjectevaluation
dc.subjectfamily involvement
dc.subjectimplementation
dc.subjectpaediatric
dc.subjectparent concern
dc.subjectFAMILY-INITIATED ESCALATION
dc.subjectMEDICAL EMERGENCY TEAM
dc.subjectPATIENT
dc.subjectINTERVENTION
dc.subjectPERCEPTIONS
dc.subjectACTIVATION
dc.titleParent escalation of care for the deteriorating child in hospital: A health-care improvement study
dc.typeJournal Article
dcterms.source.volume22
dcterms.source.number5
dcterms.source.startPage1078
dcterms.source.endPage1088
dcterms.source.issn1369-6513
dcterms.source.titleHealth Expectations
dc.date.updated2020-07-17T05:53:04Z
curtin.note

© Authors. Published in Health Expectations.

curtin.departmentSchool of Nursing, Midwifery and Paramedicine
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidGill, Fenella [0000-0003-4697-9640]
curtin.contributor.orcidLeslie, Gavin [0000-0001-8939-9801]
curtin.contributor.researcheridGill, Fenella [O-5572-2018]
dcterms.source.eissn1369-7625
curtin.contributor.scopusauthoridGill, Fenella [55164881900]
curtin.contributor.scopusauthoridLeslie, Gavin [8744839600]


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