What do professionals need for an Open-Paediatric Intensive Care Unit (PICU)? A focus group study on PICU professionals

Background PICU is a complex stressful, high-tech environment for professionals, parents and critically ill children. Literature suggests that knowing the context is crucial in determine the suitable interventions to act. Professionals' needs in the Italian context need to be investigated. The aim of the study was to highlight the healthcare professionals' perceptions of their needs regarding the concept of Open PICUs and the presence of parents during their child's stay in the PICU, without highly restricted visiting policies. Methods Qualitative approach (multi-professional focus group) was used. The transcription and categorization followed the principles of "content analysis". Criteria concerning validity, reliability, confirmability and replicability have been satisfied. Results Results identified the following 4 main categories of needs, which were considered important by the participants: communication skills, education on the centrality of parents; the organization of the presence of parents, and suitable spaces. The majority of the participants viewed Open PICUs positively but need an improvement of: communication skills, education regarding "centredness of the parent", a better organization of the presence of the parent and suitable spaces for the parent in the Unit. Conclusions Our study shows that focus group approach is useful to gain qualitative data in a PICU. Strategic health care plans ought to focus, much more than in the past, on models that allow families to stay close to their children during the most severe stages of their illness. The Family Centred Care model is not easy to implement in settings with an intensive use of technological equipment. Open PICUs are not just places where parents have more time to see their children, but require a profound transformation into a place where health professionals and technical competences, join with relational competences to achieve family empowerment. Open PICUs would be pointless, or even counterproductive, if they were not supported by improvement and major awareness of the scope of ethical practice, with a view to provide a full and competent coverage of the clinical, ethical and relational issues relating to children and their parents, even in end-of-life situations.