Introduction: The Pediatric Liver Transplant Center in Turin has been active since 1999 and is uniquely based within the adult-oriented Molinette Hospital, in close collaboration with the adjacent pediatric facility. The clinical staff involved in pediatric liver transplantation are primarily trained in adult care but receive specific training to manage pediatric patients.
Objective: This study aims to identify critical issues in the pre-, intra-, and postoperative management of pediatric liver transplant patients by healthcare professionals operating in a setting primarily designed for adult care.
Materials and Methods: An anonymous survey was distributed to 36 healthcare professionals (nurses, anesthesiologists, surgeons, etc.) involved in the pediatric transplant pathway. The questionnaire, composed of 10 multiple-choice questions, explored the psychological and relational aspects of caring for pediatric patients within an adult hospital setting. Based on the results, the project "Il mondo di Pom" ("The World of Pom") was developed. It aims to create a more child-friendly environment within the adult hospital, featuring PAL, a soft character navigating the emotional journey of loss and recovery.
Results: Among the respondents, 40% reported difficulties managing pediatric patients, and 30% felt inadequately trained for pediatric care. Nonetheless, 90% felt supported by colleagues, and only 8% believed staffing was insufficient—indicating good team collaboration. Over 60% of respondents stated that the physical environment is not adequately structured for pediatric patients and their families. Regarding communication, only 15% reported challenges in explaining medical procedures to children, and 94% found distraction tools such as music and toys helpful in pediatric care. Notably, 98% highlighted the fundamental role of parental involvement during hospitalization.
Conclusion: Managing pediatric liver transplant patients in an adult hospital setting presents specific challenges, particularly related to staff training and environmental suitability. While many professionals experience difficulties, strong team support and interdisciplinary collaboration are strengths. The physical space remains a key area for improvement. Communication with pediatric patients is generally effective, and the central role of families is widely recognized. These findings underscore the importance of targeted interventions to enhance pediatric-focused training and create more suitable spaces to ensure effective, child-centered care