Balancing Infection Control and Parental Presence in High-Consequence Infectious Disease Care for Pediatric Patients: A Tabletop Exercise

Summary: Parental presence is a critical element in pediatric care, providing emotional support that can significantly enhance a child’s well-being. However, in cases involving High-Consequence Infectious Diseases (HCIDs), this need must be carefully weighed against infection control imperatives to prevent pathogen transmission. This tabletop exercise, titled “Parental Presence During Pediatric HCID Care,” was developed to simulate and address the complex, real-world decision-making that healthcare providers face when balancing these needs in high-stakes environments. Designed for a small team consisting of three participants—representing a pediatric healthcare provider, an Infection Control Officer, and a Parent—and three facilitator presenters, this exercise introduces a scenario in which a young child with a suspected HCID is in isolation, and the parent is distressed and requesting bedside access. Through structured discussion and guided role-play, participants explore initial considerations for allowing or restricting parental presence, assess risks, and develop a preliminary action plan that balances infection prevention with family-centered care. The drill provides an immersive learning experience that highlights the importance of interdisciplinary collaboration and clear communication in HCID care, encouraging participants to examine practical measures (e.g., PPE, restricted visitation, virtual communication) and ethical challenges (e.g., the psychological needs of both child and parents). This phase concludes with a facilitated debrief, allowing participants to reflect on their decisions and insights gained. Presented as an interactive tabletop, this exercise would offer conference attendees a hands-on opportunity to engage with and refine strategies for family-centered care within infection control constraints, fostering an understanding of best practices that can be adapted across healthcare settings.