Priority 8

What are effective strategies to mitigate the impacts of prolonged inpatient hospitalizations on the general paediatric inpatient unit (GPIU)?

Concrete Wall

Prolonged inpatient hospitalizations can pose serious emotional and psychological impacts on paediatric patients who are disproportionately impacted by the hospital environment. Considering their degree of maturity and development, hospitalized children and youth may not fully understand the severity of their illness or be able to fully communicate their needs. 

Gaps in Evidence

Prolonged inpatient hospitalizations can result in heightened stress and anxiety among children and their families yet there are knowledge gaps on how to mitigate these adverse impacts. Future research is needed on strategies to mitigate stressors associated with prolonged inpatient hospitalizations in GPIUs. 

Directions for Future Research

Potential research questions and/or directions for future studies include, but are not limited to: 

Patient and Familial Support

  • What factors will minimize the fear, guild, and/or concern of parents/caregivers of children who are hospitalized long-term (e.g. supports to reduce screen time)?  

  • What are the perceptions of patients and families of their inpatient experience after they have returned home after a prolonged inpatient hospitalization?

  • What are the experiences and needs of hospitalized families, especially those who experience multiple hospitalizations?

  • How can healthcare providers best limit the negative impact or change hospitalization into a positive experience for children and their families? 

  • What unmet needs do long-term patients and their families have?

Current Practices
  • What is the definition of a “longstay” patient or a prolonged inpatient hospitalization?

  • What current practices are in place for long-stay patients?  

  • What are the models used for discussing long-stay patients with the patient’s team of healthcare providers? 

  • What best practices exist in other care settings (e.g. Newborn Intensive Care Unit [NICU], Paediatric Intensive Care Unit [PICU] regarding prolonged hospitalization, and how can these be applied to the GPIU?

  • Does the length of stay affect functional and rehabilitation outcomes for paediatric patients?

Sub-Populations
  • What is the impact of prolonged hospitalization of Inuit children and youth from northern communities on their families (e.g. family separation due to escort policy, isolation, mental health challenges)?  

  • What is the impact of prolonged hospitalization of Inuit children and youth from northern communities with developmental disabilities?

Discharge and Transitioning to At-Home Care
  • What discharge planning practices are currently in place?  

  • What does transitioning to home-care after long-term stay look like? 

Turnovers of Healthcare Providers
  • How can healthcare providers mitigate the disadvantages of staff turnover?  

  • What is the impact of continuity versus turnover of care on patients with prolonged hospitalization?

OTHER PRIORITIES