Parent's Process of Escalation of Care for Their Deteriorating Children Admitted to Paediatric Wards: A Grounded Theory.
Catia Genna, Kiara Ros Thekkan, Immacolata Dall'oglio and 4 others
PMID 40910576WHAT IT FOUND
Parents worried about a deteriorating child often first asked ward nurses or doctors for help, then sought trusted staff; staff sometimes judged parents' reliability, and without a standard parent escalation pathway responses varied.
Key findings
01Parents usually began escalation by contacting ward nurses or doctors, then sought a trusted doctor or nurse, and only parents already familiar with intensive care staff contacted the rapid response team directly.
02Staff often judged parents' reliability before acting, with concerns from parents of chronically ill children more readily accepted and anxious first-time parents sometimes minimised.
03Without a standardised parent escalation pathway, responses varied according to parent and staff characteristics, previous experience and system knowledge, and staff said a uniform protocol could improve equity.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in one Italian children's hospital, so other hospitals with different cultures may not see the same process. Parents who joined may have been more assertive than parents who declined. It did not measure how often parent escalation happened, whether staff responded promptly, or what happened to children's health outcomes. No formal parent escalation system was in place, so the findings describe informal practice.
The easy way to misread this
Do not conclude that parent escalation improved child outcomes or made care safer. This qualitative study described how parents and staff experienced escalation, but it did not measure clinical outcomes or prove that any escalation action changed a child's condition.