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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 a …
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.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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