Date of Conferral

2-13-2025

Degree

Ph.D.

School

Health Services

Advisor

Sally Willis

Abstract

One in 22 California children is diagnosed with autism spectrum disorder (ASD). In combination with sensory considerations, healthcare costs, and increased healthcare utilization, these children face a lesser quality of care and poorer health outcomes. The literature addresses healthcare needs and experiences from various viewpoints, but does not address the experiences of nurses (RN) caring for children with ASD in the pediatric intensive care unit (ICU). The purpose of this study was to gain an understanding of RN’s challenges, and the helpful strategies utilized in practice. A qualitative, grounded study approach, centered on the patient-and-family centered care conceptual framework, was used in this study. Semi structured interviews were conducted with eight RNs, with at least 1 year of experience, working in the ICU at two children’s hospitals in Los Angeles. Data was analyzed with an interpretive description process. This lead to 43 codes for question one and 26 for question two, which were then collapsed into nine and six sub-themes for each question respectively. From these, six overall themes emerged: (a) balancing significant factors, (b) lack of knowledge and unit strategies, (c) person and system level barriers, (d) inconsistent interprofessional communication, (e) adaptations are necessary, and (f) collaboration and personalization of care. These findings suggest that RNs face challenges on multiple levels but are actively seeking support to address these challenges while using a range of existing ICU strategies to care for these patients. The findings and implementation of the recommendations of this study may positively impact the care provided to children with ASD in ICUs , through addressing barriers and disseminating the identified ICU specific strategies.

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