Welcome to Paediatric Intensive Care Unit (PICU)

Welcome to Paediatric Intensive Care Unit – PIAG 025 (21MB)

Patient, Family and Care Team Partnership Agreement

Alder Hey NHS Foundation Trust has a strong tradition of excellence in patient care.  We are committed to providing patient and family centred care along with the patient’s participation.  These expectations outline our partnership agreement which is intended to provide compassionate care in an environment that promotes comfort, healing and mutual respect between the patient, family and Care Team. 

Expectations of the Patient and Care Team Partnership Agreement:

• Patients, families and Care Team (doctors, nurses, physiotherapist, etc.) will work together to provide the best possible care for the patient in a respectful environment. This includes communication of patient progress during this hospital stay.
• There must be no unauthorised photography, audio or video recording in the unit.
• Parent/carers will participate in cares necessary to encourage safe and timely discharge from PICU.
• Any physical, rude, threatening, demeaning comments or behaviours will be challenged by the Care Team. Security will be asked to intervene if negative behaviours continue after requests have been made to stop.  
• Cares will be given at agreed upon times, where possible and appropriate. We aim to establish a routine for children and would like to maintain this continuity throughout the admission.
• Any concerns about your child’s care should be made to the bedside nurse initially or nurse in charge.
• Families are welcomed and recognized as an important part of a patient’s recovery.  However, Alder Hey NHS Foundation Trust will not tolerate profanity, disruptive behaviour, or any behaviour that interferes with the care of any patient.
• Alder Hey NHS Foundation Trust has a Zero Tolerance for any alcohol or drug use on the hospital property, abusive actions or language, or any other behaviour that creates risk or threat to patients, families, visitors, or Care Team.  Anyone, including families violating our Zero Tolerance policy will be asked to leave the hospital. Care Team will call Security immediately.
• Families are welcomed to request meetings to discuss the care of their child, and these will be facilitated to the best of our ability. Requests for second opinions on care must be made to the PICU consultant in charge.

Information for parents and carers

Welcome to the Paediatric Intensive Care Unit (PICU) in Alder Hey Children’s NHS Foundation Trust. The information in this booklet is aimed at supporting parents and carers during their child’s stay.

Your child’s admission to PICU may have been planned, in which case you may have already had an opportunity to visit the unit and been shown around and told what to expect. However, your child may have been admitted directly as an emergency from within the hospital or from another hospital, by a specialist transport team for children or neonates.

The Critical Care Floor covers three areas: Intensive Care Unit, High Dependency Unit and the Burns unit. PICU has 24 beds and there is a large team of people involved in the care of your child.

It can be daunting knowing who everyone is and what they do.  An overview of some of the people in the team can be found at the back of this booklet.

How to get to PICU and gain access to the unit

PICU is located on the first floor.

For security reasons there is an intercom system in use when parents and carers wish to enter PICU. 

Parents and carers will be asked by the PICU staff which patient you have come to visit before the door will be opened. Please do not hold the door for any other people, as staff need to identify all visitors for the safety of all our patients. There are Receptionists at the front desk who will ask you to sign in before entering the unit.

What happens when your child arrives on PICU?

You may be asked to wait in the Interview Room whilst we settle your child in and carry out certain procedures/tasks that need to take place immediately upon arrival. We appreciate that this is an anxious time for you but request that you are patient whilst we assess and monitor your child.

PICU is a very specialised area, and we use an array of equipment in the care and treatment of patients. The nurse caring for your child will explain what is happening and about the equipment that is attached to your child. At the earliest opportunity a member of the medical team will speak to you about your child’s treatment and condition. We try to ensure that you are kept fully aware of your child’s condition and management throughout their stay on PICU.

Equipment

Your child may need many types of equipment to support them during their stay in PICU. For example, some equipment allows the monitoring of your child’s vital signs such as heart rate, others deliver drugs.

Your child is likely to be on a ventilator or a machine that delivers oxygen and supports their breathing. At times the machinery may be quite noisy and may sound an alarm. Please do not switch the alarms off yourself. The nursing staff will explain everything to you, but please do not be afraid to ask if you are concerned or have any questions.

Medical team

Each morning and evening, your child will be reviewed routinely by the PICU consultant, doctors and any other members of multi-disciplinary team, assigned to your child’s care. They will discuss and review your child’s progress and to discuss treatment options and the treatment plan for the day. 

Your child will then be allocated a doctor or Advanced Nurse Practitioner (ANP) to oversee the plan of care.  There will be opportunities for you to discuss your child’s care throughout the day, with the nursing and medical team. There is a residential PICU Consultant and a team of staff 24 hours a day/seven days a week should medical input be required.

Nursing team

There is always a Senior Nurse in charge of PICU as well as the Ward Manager, and they are available if you have any questions or concerns you would like to raise.

Your child will be allocated a trained nurse or an Assistant Practitioner (who are accountable to a registered nurse), depending on the level of care your child requires.

The nurse will be involved in all physical and emotional aspects of care as well as act as an advocate for your child. They will collaborate with the medical team and members of the Multi-Disciplinary Team (MDT), to ensure high standards of care are maintained throughout your child’s stay.

Please feel free to ask questions at any time regarding your child’s care, the nurse and/or Doctor will assist you in whatever you need.

Helping us to care for your child

Whilst in the PICU, your child will require specialist nursing care, but we also value your contribution.  If you wish, you can be involved in various activities, such as nappy changing, hygiene needs, reading and playing as appropriate to your child’s needs.

If you are involved with caring tasks, such, as nappy changes, you will be asked to wear a plastic apron and if required gloves.

What to do when you visit your child

Accommodation

Unfortunately, we do not provide overnight stay facilities next to the bedside as we need to be able to always deliver care to your child safely.  When your child is admitted, staff will contact Ronald McDonald House to request a room. If a room is not available or you do not meet the criteria for accommodation, but you would like to use the other facilities, such as showers, kitchens, laundry, please ask your child’s nurse or CCU receptionist about day passes to Ronald McDonald House.

If you arrive unexpectedly overnight, we have some basic emergency parent packs for you to use.

For your own wellbeing, it is important that you try to get some sleep so that you are well rested when your child is awake and needs your attention.

Telephoning the ward for information

When you are not on the ward with your child you are welcome to phone us to check on their condition at any time of the day or night. Alder Hey’s main number is 0151 228 4811.

Specifically, for PICU, you will need the phone number of the pod your child is in.

POD 1- Ext 2850

POD 2- Ext 2242

POD 3- Ext 2178

If you are staying at Ronald McDonald house, please dial 8 and then the extension number of the pod you child is in. We ask that other family members obtain information through parents only and not by telephoning the ward themselves as we cannot give information to anyone other than parents or primary carers.

Breast Feeding

Alder Hey and PICU encourage breast feeding as a way of providing nutrition for babies and infants. On the PICU your child may not be able to breast feed and if this is the case, we have facilities by Reception for mothers to express milk.  We will store the expressed milk in a fridge / freezer to be used when required. There is an electric pump on PICU, and staff can show mothers how to use it. 

If mothers have a pump at home, they are welcome to bring this in, but it will need safety checking before use. If you would like any information about Donor EBM, please ask the ward staff.

Heidi Miller is the Alder Hey Breast Feeding Coordinator and if you would like to talk to her, the ward staff will contact her.

Midwives no longer have set days that they are in the trust. If you need to see a midwife, please contact your health visitor and ask them to make a referral on your behalf and an appointment will then be made for a midwife to come to the unit to see you.

If you are a newly delivered mother, we recommend that you see the midwife and you can receive checks and advice that you would normally get if you were at home.

If you are a breastfeeding mum of a child under 6 months old, you are entitled to receive 2 vouchers per day to use in the restaurant – please ask your nurse for more details.

That means you can’t smoke anywhere – inside and outside. This includes e-cigarettes/vaping.

If you are a smoker please prepare yourself in advance for not being able to smoke while you are with us. Exposure to secondhand smoke can have serious health consequences for young patients, families and staff and cigarette butts spoil the environment at our new hospital. We thank all our visitors in advance for not smoking on site.

E-cigarettes cannot be charged anywhere within the grounds of Alder Hey.

Mobile phone use on PICU

As mentioned previously, mobile phones should be kept on silent while at the bedside on PICU. Under no circumstances can mobile phones be charged in the bed spaces or on the corridor.

Discharge

When your child is ready to be moved to the ward, we will get your child ready the ward by ‘stepping down’ their equipment to get them used to the ward environment.

Services for Parents and visitors

There are facilities at reception for parents and carers to make drinks. Please take care when carrying hot drinks and wipe up any spillages. Help keep the reception area clean and tidy by putting any food wrappers, disposable cups, etc. in the bins.

Any children using the soft play area must always be supervised by a responsible adult.

Interpreting

If you need an interpreter or need information in the language or format of your choice about the care your child is receiving, please let the ward staff know, and they will be able to organise it for you.

Shops and Restaurants

There are coin-operated vending machines available 24 hours a day.

The main atrium houses a wide variety of services. These include shopping, dining, post box, cash machine, hospital fundraising team, PALS, wheelchairs and the payment machine for the car park.

Spiritual Care

The Spiritual Care Department is centered on the Sanctuary, which is located in the lower floor of the “Tree house” accessed from level 2.

As well as the main worship space there is a quiet room where families may reflect or pray in peace and ablution facilities for those who may require them. Prayer mats and screens are also provided.

The Spiritual Care team are here for all patients and their families, whether they profess to have a faith or not. Some may feel need for prayer or wish to have their child baptized; others may just need some quiet support, someone to talk to or reassurance.

Whatever the need the, our Spiritual Care team is available Monday to Friday in office hours and provides on-call service at any time of the day or night and can be contacted through the nursing staff.

They can also assist those of other faiths who have different worship needs and can act as a link to representatives of other denominations and faiths when required.

Feedback on your child‘s care on PICU and parent satisfaction survey

We would like to hear about your experience on PICU. The purpose of these is to get feedback from parents and children, if possible, about the care we have provided so that we can address any issues and develop /improve the care we provide. We take your responses seriously and the ward team reviews all feedback and makes appropriate changes. Please ask Ward Staff for the QR code to access the anonymous parent satisfaction survey.

PALS is here to help sort out questions and concerns you may have. PALS will also advise you about making a complaint and refer you to the Complaints Service. Please speak to our PALS team about any concern you want to discuss.

If the team are helping other families, you may need to leave a voicemail. They will return your call as soon as they are able.

Research on PICU

On PICU we are committed to delivering the best care for children that we can. Research studies try to develop better treatments for all children on the unit. At some point during your child’s stay, you may be asked whether you would   be willing for your child to take part in a study by one of our research nurses. This is, of course entirely up to you and refusal to take part in a trial does not affect the treatment/care your child receives.

PICU staff and their uniforms

The following staff visit PICU frequently and have no set uniform:

Patient Diary

We encourage families to begin a diary of their child’s stay on ICU.

Often children will have little to no recollection of their time with us and find it useful later to look back at events during their stay.

The following pages can be used to begin this process. Parents may only take pictures of their child and equipment but should ask the bedside nurse before doing so.

This leaflet only gives general information.  You must always discuss the individual treatment of your child with the appropriate member of staff.  Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

© Alder Hey         Review Date: July 2028        PIAG: 025