Design and setting
Multinational survey initiated by the POKER consortium (Paediatric
Oncology Kids in Europe Research group), endorsed by the European
Society of Paediatric and Neonatal Intensive Care (ESPNIC).
We developed a web-based survey with domains based on prior studies
demonstrating potential structure–outcome links in critical care and
previously developed questionnaires.10-13 Additional
questions were designed by the POKER consortium. The survey was
constructed in accordance with the Checklist for Reporting Results of
Internet E-Surveys (CHERRIES).14 The first draft of
the questionnaire was discussed in January 2021. After several rounds of
review and piloting to assess the usability and technical functionality
of the electronic questionnaire by the POKER consortium, the final
survey included the following domains: hospital and PICU type and bed
capacity, PICU staffing patterns, hospital policies on the use of early
warning scores and rapid response teams, presence of regular
multidisciplinary clinical rounds, clinical pathways and protocols,
regular meetings between oncologists and intensivists (i.e. formal
meetings between the attending oncologist and intensivist to discuss
care planning and setting of goals), oncologist participation during
PICU multidisciplinary rounds, PICU admission policies for children with
cancer, regular debriefing and administrative multidisciplinary
meetings, and family visiting policies. The survey inquired practice
outside the COVID-pandemic regulations. The full survey is shown in the
additional supporting information.
Between February and June 2021, the members of the POKER consortium
representing 11 European countries approached PICU directors or
representatives in their country by E-mail or via established networks
and invited experienced colleagues to participate in the survey. To
avoid duplicates only one representative for each PICU was contacted.
The questionnaire was distributed online via SurveyMonkey. As this
survey was based on voluntary participation without collecting sensitive
data, an Institutional Review Board did not review this study. By
partaking in the survey, participants consented to the use of their data
for the purpose of the study.