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  • Children’s Critical Care Nursing

    Children’s Critical Care: mum with baby

The Children’s Critical Care Nursing Group focuses on improving nursing care delivery, preventing deterioration and optimising outcomes of the critically ill and deteriorating child in hospital.

We work closely with Alder Hey Children’s NHS Foundation Trust and the Children’s Nursing Research Unit as well as with colleagues in other Paediatric intensive care units in the UK and Europe.

Expertise and Subject Areas

Our team of researchers and doctoral students focuses on:

  • Paediatric Early Warning Scores
  • Optimising the outcomes of the critically ill and deteriorating child in hospital
  • Sedation-withdrawal in children
  • Reducing medication errors and improving learning from these events
  • Tool development
  • The evaluation of clinical nursing practices in critical care
  • Nursing care in paediatric traumatic brain injury
  • Endotracheal suctioning


Through our reputation for undertaking high quality research work, a high profile within the clinical field and our strong networks we are able to influence practice for example:

  • The implementation of a Paediatric Early Warning (PEW) tool within Alder Hey Children's Hospital. This has led to an active research programme focusing on paediatric early warning tools.
  • Educational developments, e.g., the multi-professional RESPOND programme that focuses on implementing better practice within the clinical setting
  • Changing clinical PICU practice to include additional monitoring (NIRS) after high risk congenital heart surgery to identify subtle deterioration sooner
  • Developing and implementing evidence based nursing care guidelines for the care of children with severe traumatic brain injury

Publications and Outputs


  • Tume LN, Coetzee M, Dryden-Palmer K, Hickey PA, Kinney S, Latour JM, Pedreira M, Sefton GR, Sorce L, Curley MAQ Pediatric Critical Care Nursing Research Priorities – Initiating International Dialogue (2015 accepted in press) Pediatric Critical Care Medicine
  • Tume LN, Ista E, Latour J (accepted 2015 in press) Editorial: A roadmap for Paediatric and Neonatal Critical Care Nursing Science in Europe: Engage, Action and Impact. Nursing in Critical Care
  • Tume LN, Copnell B (accepted 2014 in press) Endotracheal Suctioning in Critically Ill Children. Journal of Pediatric Intensive Care.
  • van Miert C, Abbot J, Verheoff F, Lane S, Carter B, McNamara PS (2013) The Development and Validation of a Clinical Severity Score for Infants with Bronchiolitis (S75), Thorax 2013; 68 (Suppl 3): A40-1 10.1136/thoraxjnl-2013-204457.82
  • Van Miert, C., Abbott, J., Verhoeff, F., Lane, S., Carter, B. & McNamara, P. (2014) Development and Validation of the Liverpool Infant Bronchiolitis Severity Score: a research protocol. Journal of Advanced Nursing. 70(10):2353-2362.
  • Wielenga J, Tume L, Latour J, van den Hoogen A (2014) Establishing neonatal intensive care nursing research priorities in 17 European countries: an e-Delphi Study. Archives Dis Childhood Fetal Neo Edn. doi:10.1136/archdischild-2014-306858

  • 2014-306858
  • Tume L, van den Hoogen A, Wielenga J, Latour J (2014) An electronic Delphi study to establish pediatric intensive care nursing research priorities in 20 European countries. Pediatric Critical Care Medicine. Vol 15 (5) e206-e213
    doi: 10.1097/PCC.0000000000000109
  • Sefton G, McGrath C, Lane S, Tume L (2014) Impact of using a Paediatric Early Warning system on unplanned admission to the Paediatric Intensive Care Unit; an observational comparison of in-hospital and external admissions. Intensive and Critical Care Nursing. doi: 10.1016/j.iccn.2014.01.001
  • Tume L and Arnold P (2014) Near Infrared Spectroscopy (NIRS) after high risk congenital heart surgery in the PICU. Cardiology and the Young. doi:10.1017/S1047951114000055
  • Tume L, Scally A, Carter B (2013) Paediatric intensive care nurses’ and doctors’ perceptions on nurse-led protocol-directed ventilation weaning and extubation. Nursing in Critical Care doi:10.1111/nicc.12055
  • Tume L, Carter B, Latten L (2012) A UK and Irish survey of enteral nutrition practices in paediatric intensive care units Br J Nutrition doi:10.1017/S0007114512003042
  • Tume L, Baines P and Lisboa P (2011) The effect of intensive care nursing interventions on the intracranial pressure in paediatric traumatic brain injury Nurs in Crit Care; 16(2): 77-84
  • Tume L, Latten L & Darbyshire A (2011) An evaluation of enteral feeding practice in the PICU Nurs in Crit Care; 15 (6): 291-299
  • Tume L Editorial (2010) Remodelling the paediatric ICU workforce: there is a case for implementing advanced nurse practitioner roles into all PICUs Nurs in Crit Care; 15(4): 165-167.
  • Tume L & Baines P (2008) A UK audit of PICU practices in severe TBI British Journal of Intensive Care; 18(3): 18(3): 84-88.
  • Tume L, Thorburn K and Sinha A (2008) A review of the intensive care management of severe traumatic brain injury in children Br J Neurosci Nurs; 4(9): 424-431.
  • Tume, L and Jinks A (2008) The effects of endotracheal suctioning in severe traumatic brain injury in children: a review Nurs in Crit care; 13 (5):232-240.
  • Tume L (2008) Impact of care interventions in children with severe traumatic brain injury in intensive care Br J Neurosci Nurs; l 4(3): 2-6.
  • Tume L (2007) The Nursing management children with severe traumatic brain injury and raised ICP in intensive care Br J Neurosci Nurs; 3(10): 461-467.
  • Tume L (2006) The deterioration of children in ward areas in a specialist children’s hospital Nurs in Crit Care; 12(1): 12-17.
  • Tume L and Bullock I (2004) The development of early warning tools to identify children at risk of deterioration on ward areas. Paediatric Nursing; 16(8): 20-23.
  • Tume L (2004) A 3 year review of emergency PICU admissions from the ward in a specialist cardio respiratory centre Care of the Critically Ill; 21(1): 4-7.
  • Tume L and Bullock I. (2002) Education to prepare nurses for new advanced roles in critical care. Care of the Critically Ill; 18(2): 48-51.
  • Carter, B. (1997) Pantomimes of Pain, Distress, Repose and Lability: the world of the preterm baby. Journal of Child Health Care. 1(1):20-25
  • Carter, B. (1995) Observing Neonates: 'real world' difficulties and dilemmas. Journal of Neonatal Nursing 1(3): 15-20.
  • Carter, B. (1989) Problems and nursing management strategies related to respiratory distress syndrome in the very preterm baby, Intensive Care Nursing. 5, 55-64.


  • Carter,B. [Ed] (1993) Manual of Paediatric Intensive Care Nursing, Chapman and Hall, London


  • May,L. & Carter,B. (1995) Nursing Support and Care: meeting the needs of the child and family with altered cerebral function. In: Carter,B. & Dearmun,A.K. [Eds] (1995) Child Health Care Nursing: Concepts, Theory and Practice. Blackwell Science: Oxford pp363-390
  • Carter,B. & Hewitt,T. (1995) - Nursing Support and Care: meeting the needs of the child and family with altered cardiovascular function. In: Carter,B. & Dearmun,A.K. [Eds] (1995) Child Health Care Nursing: Concepts, Theory and Practice. Blackwell Science: Oxford pp308-334
  • Carter,B. (1995) Nursing Support and Care: meeting the needs of the child and family with altered respiratory function. In: Carter,B. & Dearmun,A.K. [Eds] (1995) Child Health Care Nursing: Concepts, Theory and Practice. Blackwell Science: Oxford pp274-307
  • Carter, B. & Cooper,D. (1993) Care of the child with polytrauma and thermal injury. In: Carter,B. [Ed] (1993) Manual of Paediatric Intensive Care Nursing, Chapman and Hall, London. Pp 230-279

Events and News

1st International and multidisciplinary children’s critical care research summer school


Tuesday 26th & Wednesday 27th August, 2014
University of Central Lancashire, Preston, UK

Endorsed by:

World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS) logo

The children’s critical care research summer school

An increasing number of neonates and children are surviving critical illness and many have complex healthcare needs. Recovering from critical illness can be a long-term process and children and their families face many challenges. A number of disciplines have an interest in critically ill children and research collaborations across disciplines have the potential to improve health care practices and inform methodological developments. The summer school provides both essential skills and knowledge for methodological and content issues and the opportunity for researchers to collaborate with other researchers in the field. This multidisciplinary summer school, based on the University of Edinburgh’s successful adult summer school model, aims to:

  • Build national, European and international research collaborations
  • Create networks of early career and senior researchers
  • Provide high quality methods teaching opportunities

Who is the summer school intended for?

The summer school is aimed at international early career, doctoral and postdoctoral researchers from both social science and practice based health care. An early career researcher is defined as a person who is currently undertaking or who has held an MSc by research (not taught masters), MRes, MPhil, MD or PhD degree not longer than 5 years.


The fee is set at £180 per student. This includes 2 nights B&B accommodation in university residence, a course dinner on the Tuesday night and refreshments during all breaks.

Structure of the summer school

The summer school will be held over two days (Tuesday 26th & Wednesday 27th August) and is structured into keynote lectures, master classes and group sessions. The following list is a selection of topics which will be covered in keynotes and master classes:

  • Approaching a systematic review
  • Methodological master classes on: statistics, facilitating focus groups, interviewing, the Delphi approach, questionnaire design, narrative research, evaluating scoring tools
  • Writing grants and finding funding for your research
  • Writing up your research for publication
  • Demonstrating the ‘impact’ of your research
  • Realistic evaluation methodology
  • Assessing the fidelity of your research
  • How to ‘sell’ your research
  • Demonstrating the impact of your research
  • Studying complex interventions


The summer school is strictly limited to 40 participants and preference will be given to early career, doctoral and postdoctoral researchers from the social sciences and practice-based health care sciences (including allied health care professionals). The application deadline is 2nd June 2014, and if your application is successful, you will be required to pay the full amount by the 1st July 2014. Applicants must bring a poster presentation of their recent work for discussion (A short 250 word abstract is required at the time of application).

Who are the people behind the summer school and guest speakers?

The summer school involves critical care researchers at the University of Central Lancashire, Dr Lyvonne Tume and Prof Bernie Carter. We are also very excited to have Professor Martha Curley (University of Pennsylvania, USA) as our invited distinguished scholar and Professor Jos Latour (Professor in Clinical Nursing, Plymouth University, UK). These are exceptionally renowned and expert speakers in this field.

View the detailed program (.pdf 181KB)

For further information or to request an application form, please email the School of Health Research Support Team: or phone +44 (0)1772 89 3692/5532.

Previous Events

Children’s Nursing Research Unit Conference 7th May 2013 at Alder Hey Children’s NHS Foundation Trust

Courses and Postgraduate Study

  • Paediatric Intensive Care Course and High Dependency Course (UCLan)
  • Masters in Paediatric Advanced Nursing Practice (Acute & Critical care) LJMU


Linked staff in associate centres
Jennie Craske: Pain Nurse Specialist, Alder Hey Children’s NHS Foundation Trust, UK

Additional Information

For further information contact:

Dr Lyvonne Tume
School of Health
University of Central Lancashire
Preston PR1 2HE

Related Research Groups

Key links to:

  • Children’s Nursing Research Unit, Alder Hey Children’s Hospital NHS Trust
  • Erasmus Medical centre, Nursing Research Group, Rotterdam, NL
  • ESPNIC Nurse Science Section – Lyvonne Tume elected chair of this section
  • Monash University, Melbourne Australia – Dr Beverley Copnell
  • Plymouth University, UK – Professor Jos Latour

Current Projects

  • Tume, L. et al. NIRS as an earlier predictor of deterioration in high risk post-op cardiac infants
  • Tume, L. et al. Learning from medication errors in in doctors and nurses in children's intensive care
  • Tume L et al: Reducing avoidable mortality in hospitalized children through PEWs
  • Endotracheal suctioning methods in high risk cardiac infants on intensive care
  • Determining ‘usual care’ practices around sedation management and ventilation weaning in UK PICUs
  • A randomised crossover trial of open vs closed suction in high risk cardiac infants

Past Projects

  • Tume L et al: Exploring PIC nurses and doctors views of nurse-led (protocol based) ventilation weaning and extubation in a PICU
  • Tume, L. et al. A 3 round Delphi study to determine PICU and NICU nurses research priorities across Europe
  • Tume, L. , Carter, B. et al. PICU professionals views about enteral feeding practices - a UK & Irish Survey
  • Tume, L. et al. How much of the predicted calorie requirements do children in PICU actually receive?
  • Tume, L. et al. An evaluation of the Braden Q pressure ulcer risk score in a UK PICU population
  • Tume, L. et al. Predicting deterioration in hospitalised children - the use of Paediatric early warning scores
  • Tume, L. et al. Bispectral index as a better marker of sedation level in muscle-relaxed children in intensive care
  • Tume, L. et al. The effect of nursing interventions on the intracranial pressure of children with traumatic brain injury in intensive care
  • Carter, B., Cummings, J. & Anderson, C. Scoping and Mapping Community Children’s Nursing Services (CCNS) and skills and training needs for services caring for Children / Young people requiring Long Term Ventilation (LTV). Submitted to Department of Health