Impact of Pediatric Critical Care on the Family, Community, and Society.

KEY POINTS
■ PICU care involves multiple interfaces with the child, family, and community.
■ The model of family-centered care includes the specific context and needs of the family in the care plan.
■ Shared goals and wishes for the good of the child, and the use of templated approaches for conflict resolution can energize successful building of a therapeutic alliance between the child’s family and their PICU providers.
■ Early planning for disposition and special needs, including counseling, teaching, and training, is required to optimally provide for care beyond the PICU.
■ Posttraumatic stress disorder is a widely pervasive sequel of critical care that requires early intervention and long-term follow-up.
■ Skillful direction of care in the terminal scenario requires the empathetic anticipation of the needs of family and staff, and well-planned bereavement follow-up care.
■ Individualized approaches to self-care may help providers increase effectiveness and longevity on the job.
■ PICU practice offers the opportunity, beyond the walls of the hospital, for patient advocacy to decrease the incidence of childhood disease and injury.