High Dependency Care in Childrens Wards:

1

• High Dependency Care in Childrens Wards
• A preliminary exploration
• Maggie Doman
• Senior Lecturer in Nursing (Child)

2
High Dependency Care in Childrens Wards

• What is high dependency care for children?
• Background to the study
• Overview of the two phases
• Preliminary findings
• Recognising the sick child

3
What is high dependency care for children?

• This describes care provided to a child who may
  require closer observation and monitoring than is
  usually available on an ordinary childrens ward,
  although much of this care is already provided,
  with higher staffing levels than usual, in such
  locations
• (Department of Health, 1997, p7)
• Critically Ill Childrens Study and Audit (SW)

4
Background to the study

• Development of high dependency module
• Anecdotal reports from students/clinical
  colleagues
• Lack of empirical evidence
• Need for qualitative approach
• Exploration of nurses experiences
• Two phases to the study

5
Overview of phase 1

• Focus group interviews with nurses
• Range of hospitals/wards in SW represented
• Data analysis six categories
• Definitions and perceptions of high dependency
  care
• Having an HDU
• Problems in DGHs
• Skills needed for high dependency care
• Team working
• Staffing for high dependency care

6
Overview of phase 2

• Fieldwork in three childrens wards
• Participant observation
• Individual interviews
• Documentation
• Qualitative content analysis
• Confirmation and development of phase one
  findings
• Four themes
• Provisional model of high dependency care

7
Preliminary findings 4 themes

• Recognising the sick child
• Being prepared
• Working together
• Context and culture

8
Recognising the sick child

• Recognising deterioration/improvement
• part of the workload
• getting round the label

9
Provisional model of HD care

Working together

Recognising the sick child
Being prepared
Context and culture
10
High Dependency Care in Childrens Wards

• Conclusions
• Importance of recognising the sick child
• Acknowledgement of influencing factors
• Implications
• for clinical practice
• for management
• for education
• for research