Caregiver Accompaniment in Pediatric Critical Care Transport: A Systematic Scoping Review.

Abstract

Context: Family-centered care is a critical component of critical care interfacility and medical retrieval transport (MRT) services. These services provide a critical bridge for a physiologically and psychologically unique population often best served in specialized, tertiary centers. Caregivers often wish to accompany patients during MRT. However, there is currently little research on the impact of caregiver accompaniment on MRT.

Objective: The aim of the study is to determine: 1) What are caregiver attitudes to accompanied and unaccompanied MRT? 2) What are healthcare provider attitudes to caregiver presence? 3) What are patient attitudes to caregiver presence? and 4) Are there differences in patient outcome depending on caregiver presence?

Data sources: Data sources are MEDLINE, Embase, and CINAHL.

Study selection: Studies with a focus on patient, caregiver, or family-oriented care practices in MRT. Reviewed articles were not restricted unless they discussed neonatal transport, palliative transport, were non-English, or were conference proceedings.

Data extraction: We screened 1373 articles, with 45 full-text articles reviewed. After removal of duplicates and abstract-only results, 25 articles remained. Three additional articles were found in references of reviewed articles.

Results: Articles generally supported caregiver presence on MRT, with caregivers and providers in agreement. However, for many services, space was a limiting factor controlling when caregivers could travel.

Limitations: There is a paucity of literature on this topic, and studies were entirely from English-speaking countries.

Conclusions: Caregivers and healthcare providers largely prefer caregiver accompaniment on MRT services. There is little data on patient perspectives and transport-related adverse events affecting patient outcomes.