A report led by Dele Davies, M.D., UNMC vice chancellor for academic affairs, provides guidelines for parental presence at the hospital bedside should a child have suspected or proven Ebola virus disease or other highly consequential infection. The guidelines were published in the September issue of the journal Pediatrics.
“This is a very complicated issue and was one of the most frequent things that pediatricians sought guidance for during the Ebola crisis,” said Dr. Davies, who has served on the Committee on Infectious Diseases for the American Academy of Pediatrics (AAP) for the past three years. “It’s a serious psycho-social issue, because children obviously need and want their parents to be with them.”
The guidelines developed help meet the needs of the patient and the family while also posing the least risk to providers and health care organizations, he said.
The optimal way to minimize risk, Dr. Davies said, is to limit contact between the child being treated and the family members/caregivers. At the same time, caregivers must strive to meet the emotional support needs of both the patient and family.
“At times, parental presence may be deemed to be in the best interest of the patient,” Dr. Davies said. “When this is the case, a strong effort should be made to limit potential risks of exposure to the parent, the health care providers and the community.”
The decision to allow parental/caregiver presence should be made in consultation with a team, Dr. Davies said. Ideally, this team should include infection control experts, state and/or local public health authorities, child life personnel and the hospital legal team.
Many factors need to be considered, Dr. Davies said, such as the ability of the facility to manage Ebola and provide isolation for the child under investigation and the ability of the parent to follow instructions, including appropriate donning and doffing of personal protective equipment.
“The bottom line is that hospitals must think ahead and develop a clear plan that they can follow,” Dr. Davies said.
Carrie Byington, M.D., chair of the AAP Committee on Infectious Diseases, joined Dr. Davies in developing the guidelines, which had strong input from other members of the committee and AAP partner organizations. Dr. Byington is a pediatrician at the University of Utah School of Medicine.
It is a very difficult situation as lots of emotions are involved . considering the requirement of PPE and the space occupied by parents in the room we must try to keep the parents away from the infectious child.
The presence of parents to support the child requires a lot of think through as the age of the child and ability of parents to Don and doff at the same time to observe certain caregiving without interrupting the same