Parental Presence at the Bedside of Critically Ill Children in the Pediatric Intensive Care Unit: A Scoping Review

Background: Critically ill children in the Pediatric Intensive Care Unit (PICU) and their parents need to be together. Beyond team rounds and resuscitation, parental presence at the bedside (PPB) is necessary for PICU application of family centred care. Unlike previous research which emphasizes parent-healthcare team interactions, our research question focuses on the parent-child dyad. The primary objectives were to determine the breadth and scope of the published literature addressing PPB of critically ill children in the PICU, and to identify the studies that directly assess PPB as an intended outcome rather than an incidental finding.

Methods: Five online databases were used to identify peer reviewed and grey literature from 1960- June, 2020. Both screening and data extraction were performed by two independent reviewers. At all stages, disagreements were managed by consensus discussion or a third, tie-breaking vote.

Results: Of 204 included publications, 89 (44%) articles directly assessed PPB, with 63 (31%) having an element of PPB as a primary objective. Amount or quality of time was addressed by 112 (55%) studies (55 [62%] of 89 total direct assessments). Barriers and enablers to PPB were addressed by 155 (76%) articles (66 [74%] directly). The impact or outcomes of PPB were addressed by 137 (67%) articles (68 [76%] directly). While only 7 articles were published in the first two decades of our search (1962-1982), 18 articles were published in 2019 alone.

Conclusion: PPB is of increasing interest and importance to researchers. Systematic reviews of the literature directly assessing PPB in each of the arms of this scoping review –amount and quality, barriers and enablers, and outcomes– are warranted.