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Prevalence and sources of tension in paediatric inpatient care
  1. Ceit Jesmont1,
  2. Katy Wood1,
  3. Chris O'Brien2,
  4. Yincent Tse3,4
  1. 1 Great North Children's Hospital, Newcastle Upon Tyne, UK
  2. 2 Paediatric Respiratory Unit, Great North Children's Hospital, Newcastle Upon Tyne, UK
  3. 3 Department of Paediatric Nephrology, Great North Children's Hospital, Newcastle Upon Tyne, UK
  4. 4 Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Yincent Tse, Department of Paediatric Nephrology, Great North Children's Hospital, Newcastle Upon Tyne, UK; yincenttse{at}

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Rising numbers of children with medical complexity and the availability of life-sustaining treatment engender challenging decisions and opportunities for conflict. Conflict encompasses active disagreement between parties, resulting in relationship breakdown and suboptimal patient care. Recent work categorises conflict and its impact on paediatric hospital staff,1 2 but prevalence remains undescribed. We report the prevalence of conflict within a large UK children’s hospital as part of the wider term ‘tension’, which also encompasses the themes of ethics, unresolved safeguarding concerns and end-of-life issues.

We prospectively conducted a twice weekly survey to nursing and medical teams in our 12-ward tertiary children’s hospital, over a 4-week period in June/July 2019, to identify sources of tension in patients admitted for ≥5 days duration. Sources of ‘tension’ were devised via a multidisciplinary focus group. Clinical data were extracted from electronic patient records. Our trust governance board preapproved the survey.

During the 4-week period, 1295 children were admitted (median age 5 years, range 0–17), of which 153 (12%) stayed ≥5 days. Patients had …

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  • Contributors COB and YT conceived the study. CJ and KW acquired and analysed the data. All authors designed the study, drafted, revised and approved the final document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.