Up to the Challenge: Adapting Pediatric Intensive Care During a Global Pandemic

Myra Pereira; Olugbenga Akinkugbe; Laura Buckley; Elaine Gilfoyle; Sarah Ibrahim; Melissa McCradden; Sarah Somerton; Karen Dryden-Palmer

doi:10.3389/fped.2022.910018

Up to the Challenge: Adapting Pediatric Intensive Care During a Global Pandemic

Front Pediatr. 2022 Jul 13:10:910018. doi: 10.3389/fped.2022.910018. eCollection 2022.

Authors

Myra Pereira¹, Olugbenga Akinkugbe¹, Laura Buckley^{1

2

3}, Elaine Gilfoyle^{1

2

3}, Sarah Ibrahim^{2

4

5}, Melissa McCradden^{6

7

8}, Sarah Somerton¹, Karen Dryden-Palmer^{1

2}

Affiliations

¹ Department of Critical Care Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
² SickKids Research Institute, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
³ Lawrence S. Bloomberg Faculty of Nursing, Centre for Advancing Collaborative Healthcare and Education (CACHE), University of Toronto, Toronto, ON, Canada.
⁴ Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁵ Centre for Advancing Collaborative Healthcare & Education (CACHE), University of Toronto, Toronto, ON, Canada.
⁶ Department of Bioethics, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
⁷ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁸ Genetics and Genomic Biology Research Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.

Abstract

Background: The COVID-19 pandemic has strained health systems world wide. In our region, surging numbers of critically ill adult patients demanded urgent system-wide responses. During the peak of the pandemic, our Pediatric Intensive Care Unit (PICU) team redesigned the existing educational resources and processes of care to ensure for adult patients for the first time in the hospital's history.

Aim: Describe the experiences and impacts of the rapidly initiated Adult COVID-19 Program on health care providers (HCP) and family members. Havelock's Theory of Change framed the examination of Adult COVID-19 Program participant experiences and surfaced lessons learned.

Materials and methods: A quality improvement review was employed to collect feedback about the program experience from the health care team and patient's family members. HCP completed a questionnaire 10 months following the implementation of the program and feedback from family members was provided during the program was obtained. Havelock's Theory of Change was used to explore trends and frame participants' experiences.

Results: Pediatric Intensive Care Unit bedside team members and clinical leaders (n = 17), adult hospital partners (n = 3), and family members (n = 8) participated. HCP describe; motivation and readiness; concern for personal safety and uncertainty experienced in the early program phases; the importance of supports and resources; use of relationships and collaboration to facilitate change; the emotional impacts of this unique experience; and opportunities for individual and team growth. An overarching theme of 'doing our part to help' emerged. Family members described the positive impacts of family-centered interventions offered, individualized care, and shock at their family member's illness.

Conclusion: The PICU team rapidly adapted to provide care for adults at the peak of the pandemic. Family members expressed feeling grateful for the care their loved ones received in the pediatric setting. The experience of caring for adult patients with COVID-19 was a source of tension, personal growth, and meaning for the pediatric intensive care team.

Keywords: COVID-19; adaptation; adult critical care; interprofessional care; pandemic; pediatric intensive care.