Critically ill children require highly specialised, technologically advanced, time-sensitive, and multidisciplinary care across a range of acute healthcare settings, including paediatric intensive care units (PICUs). In this context, safety goes beyond the prevention of adverse events, technical errors, or clinical complications. Safe care for critically ill children necessitates the combination of competent clinical practice, effective interprofessional teamwork, trustworthy communication, early recognition of patient deterioration, organisational support, and developmentally appropriate care (World Health Organization WHO, 2021). The care of critically ill children differs substantially from adult critical care, as children rely on parents or caregivers for emotional support, interpretation of symptoms, communication of preferences, and participation in care decisions. Consequently, families constitute an essential component of safety rather than serving as external observers. Family-centred care for critically ill children is grounded in respect, information sharing and partnership. In practice, this includes family presence during rounds, shared decision-making and individualised communication about the child’s care (Richards et al., 2017; Terp et al., 2021). Family involvement is especially important to the concept of safe care for critically ill children, as parents contribute to clinical vigilance, continuity of information, and recognition of subtle changes in the child’s condition. Additionally, family experiences with communication, inclusion, emotional support, and partnership influence parental trust, satisfaction, and perceived safety of care. Recent evidence suggests that family-centred care interventions in paediatric critical care may improve family satisfaction and encourage more collaborative relationships between families and healthcare professionals, although implementation remains variable and context dependent (Aljawad et al., 2025; Andretta et al., 2025; Charles et al., 2026). Despite growing attention to patient safety and family-centred care, the concept of safe care for critically ill children remains insufficiently defined. Existing literature often examines individual aspects of safety, such as infection prevention, medication safety and staffing. Other studies focus on communication, adverse event reporting or family participation. However, these elements are rarely integrated into a coherent conceptual framework. This fragmentation limits the development of theory, measurement instruments and quality improvement strategies that address the specific needs of critically ill children and their families. A concept analysis of safe care for critically ill children is therefore necessary to clarify the defining attributes, antecedents, consequences, and empirical referents of this concept. Such analysis can support research, practice and policy by clarifying how clinical, organisational and family-centred dimensions interact to create safe care for critically ill children.
Kohanová et al. (Sun,) studied this question.