Highlights
- •Improvements made to stabilize hospitalized adolescents with eating disorders (EDs).
- •Nurses, care assistants, hospitalists (HCWs) were satisfied with system changes.
- •HCW themes include awkwardness/uncertainty, family dynamics, therapeutic boundaries.
- •HCWs suggested ideas of effective changes to ED hospitalization.
Abstract
Purpose
To describe the perceptions of inpatient pediatric hospitalist physicians (HPs), registered
nurses (RNs), and care assistants (CAs) at a tertiary pediatric hospital regarding
caring for children with eating disorders (EDs) who are hospitalized for medical stabilization.
Design and Methods
A qualitative descriptive study was conducted using semi-structured individual interviews
with aforementioned health care workers (HCWs) to explore their perspectives on caring
for children/adolescents with EDs in relation to recent initiatives to transform their
care. These initiatives focused on admitting patients to a designated “ED Unit”, development
of an ED consult team, providing ED education to staff, and development of ED standardized
order sets (SOSs).
Results
Twenty HCWs representing the three disciplines completed individual interviews. Most
participants reported that the system changes led to more consistent care of patients
with ED. Content analysis of the interviews revealed the following themes: awkwardness
and uncertainties of care, navigating family dynamics, establishing therapeutic boundaries,
and finding rewards in ED care.
Conclusions
Education, structure, and support for staff improved care for adolescents with EDs
as perceived by HCWs. HCWs found satisfaction in providing care during the medical
stabilization process. Study findings were positive for staff and future studies should
include perceptions of patients/families to further design a therapeutic environment.
Practice Implications
Providing a standardized order set, expert consult team, and ongoing staff training
can strengthen the therapeutic hospital environment for adolescents with EDs. Pediatric
hospitals can provide excellent care for children with EDs while supporting their
staff to provide a therapeutic environment.
Keywords
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Article info
Publication history
Published online: March 07, 2017
Accepted:
February 6,
2017
Received:
June 20,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
