Perceptions of Caring for Adolescents With Eating Disorders Hospitalized on a General Pediatric Unit

Purpose: To describe the perceptions of inpatient pediatric hospitalist physicians (HPs), registered nurses (RNs), and care assistants (CAs) at a tertiary pediatric hospital regarding caring for children with eating disorders (EDs) who are hospitalized for medical stabilization. Design and Methods: A qualitative descriptive study was conducted using semi-structured individual interviews with aforementioned health care workers (HCWs) to explore their perspectives on caring for children/adolescents with EDs in relation to recent initiatives to transform their care. These initiatives focused on admitting patients to a designated ED Unit, development of an ED consult team, providing ED education to staff, and development of ED standardized order sets (SOSs). Results: Twenty HCWs representing the three disciplines completed individual interviews. Most participants reported that the system changes led to more consistent care of patients with ED. Content analysis of the interviews revealed the following themes: awkwardness and uncertainties of care, navigating family dynamics, establishing therapeutic boundaries, and finding rewards in ED care. Conclusions: Education, structure, and support for staff improved care for adolescents with EDs as perceived by HCWs. HCWs found satisfaction in providing care during the medical stabilization process. Study findings were positive for staff and future studies should include perceptions of patients/families to further design a therapeutic environment. Practice Implications: Providing a standardized order set, expert consult team, and ongoing staff training can strengthen the therapeutic hospital environment for adolescents with EDs. Pediatric hospitals can provide excellent care for children with EDs while supporting their staff to provide a therapeutic environment. (C) 2017 Elsevier Inc. All rights reserved.