Family Presence at the Bedside in the Pediatric Intensive Care Unit
Back to course
Video Transcription
Video Summary
Asset Subtitle
Patient and Family Support, Ethics End of Life, Pediatrics, 2022
Asset Caption
INTRODUCTION: Family presence improves medical decision making in the pediatric ICU (PICU) but may also provide emotional and clinical benefits.  We hypothesized that family presence would be associated with pain, agitation, and delirium during PICU admission and with post-discharge health-related quality of life (HRQL). METHODS: This is a retrospective observational cohort study of children admitted to the Seattle Children’s PICU 2011-2017 who consented for post-discharge HRQL testing. Family presence was categorized as percent of PICU time with a family member present: 90-100%, 80-89%, 70-79%, 60-69%, and < 60%.  We used chi-square and ANOVA tests to compare factors associated with family presence, and linear and logistic regression to analyze associations between family presence and continuous outcomes and decline in HRQL. RESULTS: We identified 546 patients with mean age 5.9 years and mean maximum PELOD score of 3.0. Most children had family at the bedside 100% of the time (median 100%, IQR 94-100%). White patients (89%) were more likely to have ≥90% family presence compared to Latino (85%), Asian (78%), and Black (68%) patients (p < 0.05). Family presence < 90% of the time was also associated with a family language other than English, severe cognitive disability in the child, higher maximum PELOD score, longer PICU length of stay, public vs. private insurance, and higher distressed community index (DCI). Family presence was significantly associated with days of moderate-severe pain (0.8 vs. 1.1 days for ≥90% vs. < 60% presence; p=0.01), days of agitation (0.8 vs. 2.6 days for ≥90% vs. < 60% presence; p=0.001), and days of delirium (1.0 vs. 3.9 days for ≥90% vs. < 60% presence; p < 0.001). These associations remained significant after adjusting for age, maximum PELOD score, and DCI. Patients were more likely to have a clinically important decline in HRQL score from baseline to discharge (>4.5 points) if they had family present at the bedside < 90% of the time (OR 1.6, p=0.1) adjusting for age, maximum PELOD score, and DCI. CONCLUSIONS: Family presence at the bedside is lower for vulnerable patients.  Lower family presence is associated with more days of pain, agitation, and delirium in the PICU, and may contribute to post-discharge HRQL decline. Supporting family presence at the bedside may improve patient outcomes.
Meta Tag
Content Type Presentation
Knowledge Area Patient and Family Support
Knowledge Area Ethics End of Life
Knowledge Area Pediatrics
Knowledge Level Intermediate
Knowledge Level Advanced
Membership Level Select
Tag Communication
Tag Ethics and End of Life
Tag Pediatrics
Tag Delirium
Year 2022
family presence
pediatric ICU
psychological benefits
short-term clinical outcomes
retrospective cohort study


Society of Critical Care Medicine

500 Midway Drive
Mount Prospect, IL 60056 USA

Phone: +1 847 827-6888
Fax: +1 847 439-7226

Contact Us

About SCCM


Advertising & Sponsorship




Patients & Families

Surviving Sepsis Campaign

Critical Care Societies Collaborative

kisspng-facebook-social-media-computer-icons-linkedin-soci-gray-5ac493cf1c2975.7867418415228323351154  - KW Symphony    Gray twitter 3 icon - Free gray social icons    Gray linkedin 3 icon - Free gray site logo icons    Gray instagram icon - Free gray social icons    YouTube Icon Gray Box - HONOR VETERANS NOW


© Society of Critical Care Medicine. All rights reserved.   |    Privacy Statement    |    Terms & Conditions
The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.

Android App Download IOS App Download Powered By