title: Do You Know My Child? Continuity of Nursing Care in the Pediatric Intensive Care Unit.
abstract: BACKGROUND
  Parents of children with complex, chronic conditions report a desire for continuity of care, but relatively little is known about the ways in which nursing continuity of care occurs and the extent to which it is delivered in the inpatient setting.
  
  
  OBJECTIVE
  The objective of this analysis, which arose from a study on best practices in parent/nurse interactions in the pediatric intensive care unit (PICU), was to explore the delivery of continuity of nursing care in the PICU from the perspective of both parents and nurses.
  
  
  METHODS
  A qualitative, grounded theory study using situational analysis was conducted with seven parents and 12 nurse participants from a single PICU. Data sources included in-depth interviews, observation, and organizational written materials. Data were coded and analyzed using memoing and situational and positional maps to highlight emerging themes, context, and positions within the data.
  
  
  RESULTS
  Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen. Nurses understood this need but faced both contextual and personal challenges to achieving continuity, including fluctuations in staffing needs, training demands, fear of emotional entanglement, and concern for missed learning opportunities.
  
  
  CONCLUSIONS
  Continuity of nursing care is highly valued by parents of children with complex chronic condition in the PICU, but significant barriers to optimal delivery exist within the current critical care environment. Mechanisms for supporting nurses to deliver continuity of care are needed, as are alternative ways to help parents feel that all nurses caring for their child have the knowledge necessary to deliver safe and compassionate care.
authors.affiliation: Jennifer Baird, PhD, MSW, RN, is Research Fellow, Boston Children's Hospital, Massachusetts. Roberta S. Rehm, PhD, RN, FAAN, is Associate Professor, School of Nursing, University of California, San Francisco. Pamela S. Hinds, PhD, RN, FAAN, is Director, Nursing Research and Quality Outcomes, Children's National Medical Center, Washington, DC. Christina Baggott, PhD, RN, PNP-BC, is Clinical Research Nurse Practitioner, Pediatric Oncology, Stanford University, Palo Alto, California. Betty Davies, PhD, RN, FAAN, is Professor Emeritus, School of Nursing, University of Victoria, British Columbia, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Baird
authors.forename: Roberta S
authors.initials: RS
authors.lastname: Rehm
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinds
authors.forename: Christina
authors.initials: C
authors.lastname: Baggott
authors.forename: Betty
authors.initials: B
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003266:Continuity of Patient Care; D003422:Critical Care; D005260:Female; D066296:Grounded Theory; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009740:Nursing Staff; D010290:Parents; D055815:Young Adult