1195: Hourly Patterns of Caregiver Presence in the Picu: A Descriptive Study

Introduction: Caregiver presence in the PICU promotes the delivery of family-centered care, enhances communication, and mitigates potential psychological trauma. However, caregivers must balance time at the hospital with other responsibilities, including work and family demands. Previous studies have quantified family presence and identified racial and socioeconomic disparities in the amount of time caregivers are able to be at bedside. However, detailed patterns of caregiver presence have not been described. Understanding such patterns could provide valuable insights to medical and research teams seeking to engage with families more effectively. Therefore, we aimed to describe hourly trends in caregiver presence in our PICU, hypothesizing peak presence during morning rounds. Methods: We performed a single center prospective point prevalence study in our 75-bed urban PICU. We observed caregiver presence during 14 separate 48-hr epochs between August 2022 and June 2023. Eligible subjects were children with >/=2 and < 120 PICU days at screening. Bedside nurses continuously documented caregiver presence for each 48-hr epoch. We described presence by hour, combining all days and stratifying by weekdays and weekends. Children with caregivers present 0% or 100% of the time were excluded to focus on those with variable presence patterns. A child was considered as having a caregiver present if at least one caregiver was at bedside for at least one minute of a given hour. Results: Among 82 subjects, bedside presence varied by hour, with the highest percentage (>50%) of children having a caregiver present 10 am-8 pm (peak at 12 pm) and the lowest percentage (< 40%) having a caregiver present overnight and early morning. Notably, the timeframe during which family-centered rounds occur (8–10 am) showed limited overlap with peak caregiver presence. While overall patterns of presence were similar between weekdays and weekends, caregivers appeared to be present earlier in the day (during rounding hours) on weekends compared to weekdays. Conclusions: Medical teams may connect most successfully with caregivers at the bedside in late morning through early evening. Further study is necessary to best understand why these patterns of presence exist and how to best support families and care teams to optimize communication.