(788) Project KIDDOS: Kid Integration During Delivery of ICU Services (Child Support in an Adult ICU)

Introduction: Family-centered care in the Intensive Care Unit (ICU) is endorsed by the Society of Critical Care Medicine. As an adult ICU, we previously had no infrastructure to support children visiting patients in the ICU or during end of life (EOL) care (and no age limitation). Project KIDDOS aimed to determine the need for child support and, if indicated, establish an integrated child education system in an adult ICU.

Methods: Data regarding children visitors for a 36-bed adult ICU at an urban, academic medical center was collected daily over 5-months. A multidisciplinary quality improvement team led by a clinical education specialist, with ICU nurses, an advanced practice provider, and physician representatives performed a literature review and needs assessment. Materials were integrated into the ICU daily paradigm through educational efforts, emails, and staff meetings.

Results: Our 36-bed adult ICU receives more than 1,600 admissions each year, creating a significant need for family support. Over a period of 5 months (11/2023 to 4/2024), 325 occurrences of children visitors (CV) were recorded. The majority of CV ranged from ages 3 to 14 years old. There were significantly more CV on weekends (defined as Saturday/Sunday visitation) with an average of 3.23 per day on weekends compared to 1.72 per day on weekdays (p = 0.007). Tuesday and Thursday were the days of the week with the least number of CV. Review of literature and SCCM resources helped form our child education packets with ICU-specific materials. The KIDDOS team obtained stuffed animals with built in recorders, allowing augmented taping of a patient’s heartbeat. These stuffed animals were then provided to families with children to support them through EOL care. This stuffed animal EOL program was successfully rolled out to the 150+ ICU beds across our academic hospital.

Conclusions: Children are frequent visitors in our adult academic urban ICU. A child support program is needed to support family centered care. Project KIDDOS leveraged its data to support a hospital grant application for further healthcare resource support (printing packets/crayons) and purchase more stuffed animals. Exploration of further resource support may be indicated for weekends. Future steps are evaluating staff impact and family satisfaction data.