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Hoeben H, Obermann-Borst SA, Stelwagen MA, van Kempen AAMW, van Goudoever JB, van der Schoor SRD, van Veenendaal NR. 'Not a goal, but a given': Neonatal care participation through parents' perspective, a cross-sectional study. Acta Paediatr 2024. [PMID: 38436526 DOI: 10.1111/apa.17179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/25/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
AIM To explore parents' perspectives regarding participation in neonatal care, with focus on the family integrated care (FICare) model utilised as a tool to enhance parent-infant closeness. Additionally, we describe experiences in different architectural settings. METHODS An online survey, categorised by four FICare pillars, was distributed through social media to parents of newborns hospitalised to Dutch neonatal wards between 2015 and 2020. Quantitative findings were summarised using descriptive statistics, while open-ended responses were thematically analysed. RESULTS Among the 344 respondents (98% mothers), most reported feeling involved in care (315/340). However, 79% also felt separated from their infant (265/337). Irrespective of architectural settings, parents reported incomplete implementation of FICare pillars: 14% was invited to educational sessions (parent education), 51% discussed family-specific care plans (staff education), 21% was facilitated in connecting with veteran parents (psychosocial support) and 22% received couplet-care (environment). Although 65% of parents were invited to attend clinical rounds, 32% actively participated in decision making. Thematic analysis revealed fundamentals for feeling welcome on the ward, peer-to-peer support, psychosocial support and participation in clinical rounds. CONCLUSION Overall, parents expressed satisfaction with participation in neonatal care. However, structural implementation of FICare lacks. Regardless of architecture, expanding parent participation beyond presence requires attention.
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Affiliation(s)
- Hannah Hoeben
- Department of Pediatrics/Neonatology, OLVG, Amsterdam, The Netherlands
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, VU University, Amsterdam, The Netherlands
| | | | | | | | - Johannes B van Goudoever
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, VU University, Amsterdam, The Netherlands
| | - Sophie R D van der Schoor
- Department of Pediatrics/Neonatology, OLVG, Amsterdam, The Netherlands
- Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Nicole R van Veenendaal
- Department of Pediatrics/Neonatology, OLVG, Amsterdam, The Netherlands
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, VU University, Amsterdam, The Netherlands
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Harlow AB, Ledbetter L, Brandon DH. Parental presence, participation, and engagement in paediatric hospital care: A conceptual delineation. J Adv Nurs 2023. [PMID: 38037504 DOI: 10.1111/jan.15996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
AIM To delineate between the concepts of parental presence, participation, and engagement in paediatric hospital care. DESIGN The concepts' uses in the literature were analysed to determine attributes, influences, and relationships. METHODS Delineations of each concept are established and conceptual definitions are proposed following Morses' methods. DATA SOURCES MEDLINE (PubMed); CINAHL, PsycINFO, Sociology Source Ultimate (EBSCOhost); Embase, Scopus (Elsevier); Google Scholar. Search dates October 2021, February 2023. RESULTS Multinational publications dated 1991-2023 revealed these concepts represent a range of parental behaviours, beliefs, and actions, which are not always perceptible to nurses, but which are important in family-integrated care delivery. Parental presence is the state of a parent being physically and/or emotionally with their child. Parental participation reflects parents' performing caregiving activities with or without nurses. Parental engagement is a parents' state of emotional involvement in their child's health and the ways they act on their child's behalf. CONCLUSION These concepts' manifestations are important to parental role attainment but may be inadequately understood and considered by healthcare providers. IMPLICATIONS Nurses have influence over parents' parental presence, participation, and engagement in their child's care but need support from healthcare institutions to ensure equitable family-integrated care delivery. IMPACT Problem: Lack of clear definition among these concepts results in incomplete and at times inequitable family-integrated care delivery. FINDINGS Parental presence is an antecedent to parental participation, and parental presence and participation are elements of parental engagement. The concepts interact to influence one another. IMPACT Hospitalized children, their families, nurses, and researchers will benefit through a better understanding of the concepts' attributes, interactions, and implications for enhanced family-integrated care delivery.
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Affiliation(s)
| | - Leila Ledbetter
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Debra H Brandon
- Duke University School of Nursing, Durham, North Carolina, USA
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Hoeben H, Alferink MT, van Kempen AAMW, van Goudoever JB, van Veenendaal NR, van der Schoor SRD. Collaborating to Improve Neonatal Care: ParentAl Participation on the NEonatal Ward-Study Protocol of the neoPARTNER Study. Children (Basel) 2023; 10:1482. [PMID: 37761442 PMCID: PMC10527908 DOI: 10.3390/children10091482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
Parents are often appointed a passive role in the care for their hospitalised child. In the family-integrated care (FICare) model, parental involvement in neonatal care is emulated. Parental participation in medical rounds, or family-centred rounds (FCR), forms a key element. A paucity remains of randomised trials assessing the outcomes of FCR (embedded in FICare) in families and neonates, and outcomes on an organisational level are relatively unexplored. Likewise, biological mechanisms through which a potential effect may be exerted are lacking robust evidence. Ten level two Dutch neonatal wards are involved in this stepped-wedge cluster-randomised trial FCR (embedded in FICare) by one common implementation strategy. Parents of infants hospitalised for at least 7 days are eligible for inclusion. The primary outcome is parental stress (PSS:NICU) at discharge. Secondary outcomes include parental, neonatal, healthcare professional and organisational outcomes. Biomarkers of stress will be analysed in parent-infant dyads. With a practical approach and broad outcome set, this study aims to obtain evidence on the possible (mechanistic) effect of FCR (as part of FICare) on parents, infants, healthcare professionals and organisations. The practical approach provides (experiences of) FICare material adjusted to the Dutch setting, available for other hospitals after the study.
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Affiliation(s)
- Hannah Hoeben
- Department of Paediatrics/Neonatology, OLVG, 1091 AC Amsterdam, The Netherlands; (H.H.); (M.T.A.); (A.A.M.W.v.K.); (N.R.v.V.)
- Department of Paediatrics, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Milène T. Alferink
- Department of Paediatrics/Neonatology, OLVG, 1091 AC Amsterdam, The Netherlands; (H.H.); (M.T.A.); (A.A.M.W.v.K.); (N.R.v.V.)
- Department of Paediatrics, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Anne A. M. W. van Kempen
- Department of Paediatrics/Neonatology, OLVG, 1091 AC Amsterdam, The Netherlands; (H.H.); (M.T.A.); (A.A.M.W.v.K.); (N.R.v.V.)
| | - Johannes B. van Goudoever
- Department of Paediatrics, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Nicole R. van Veenendaal
- Department of Paediatrics/Neonatology, OLVG, 1091 AC Amsterdam, The Netherlands; (H.H.); (M.T.A.); (A.A.M.W.v.K.); (N.R.v.V.)
- Department of Paediatrics, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Sophie R. D. van der Schoor
- Department of Paediatrics/Neonatology, OLVG, 1091 AC Amsterdam, The Netherlands; (H.H.); (M.T.A.); (A.A.M.W.v.K.); (N.R.v.V.)
- Department of Neonatology, Wilhelmina Children’s Hospital, 3508 AB Utrecht, The Netherlands
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Ansari NS, Franck LS, Tomlinson C, Colucci A, O’Brien K. A Pilot Study of Family-Integrated Care (FICare) in Critically Ill Preterm and Term Infants in the NICU: FICare Plus. Children (Basel) 2023; 10:1337. [PMID: 37628336 PMCID: PMC10453905 DOI: 10.3390/children10081337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
Family-integrated care (FICare) is associated with improved developmental outcomes and decreased parental mental health risks in stable preterm infants. However, less is known about its application in critically ill infants who are at greater risk for adverse outcomes. The objective of this study was to assess the safety and feasibility of implementation of an augmented FICare program, FICare Plus, in critically ill infants in the first few weeks of life. Resources were specifically developed for staff and parents to support earlier parental engagement in infant care. Infant health outcomes and standardized measures of parental stress, anxiety and parenting self-efficacy were also collected using standardized questionnaires: State -Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS: NICU), Perceived Parenting Self-Efficacy Tool and Family Centered Care Survey. The t-test or Wilcoxon rank-sum test were used to compare continuous variables, while the Chi-square or Fisher exact test were used for categorical variables, respectively. In this prospective cohort study, 41 critically ill infants were enrolled: 17 in standard care (SC) and 24 in the FICare Plus group. The tools and procedures developed for FICare Plus successfully supported greater engagement in the care of their infants with no increase in adverse events and no increase in parental stress. Parents in the FICare Plus cohort felt confident to participate in their infant's care. The staff also found this model of care acceptable and well adopted. Preliminary measures of infant efficacy were similar in both groups. Total anxiety scores were high among all parents at enrollment (87 (67-94) vs. 70.5 (66-86); p-value 0.22). However, the scores prior to discharge were lower in FICare Plus group (78 (71-90) vs. 63 (52-74.5); p-value 0.02). This pilot study showed that it is feasible and safe to implement family-integrated care in critically ill infants.
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Affiliation(s)
- Najmus Sehr Ansari
- Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada; (C.T.); (K.O.)
- Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Linda S. Franck
- School of Nursing, University of California, San Francisco, CA 94143, USA;
| | - Christopher Tomlinson
- Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada; (C.T.); (K.O.)
- Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Anna Colucci
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada;
| | - Karel O’Brien
- Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada; (C.T.); (K.O.)
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada;
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Stouffer JW, Gardner FC, Myers CA, Doheny KK. Family-Integrated Neonatal Music Therapy: A Descriptive Pilot Study of Parental Perceptions on Music Therapy Participation and Long-Term Influences. Neonatal Netw 2023; 42:145-155. [PMID: 37258295 DOI: 10.1891/nn-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 06/02/2023]
Abstract
Purpose: Following a family-integrated music therapy (MT) approach, describe parental perceptions on the use of music with maternal voice to soothe and connect with the infant and the long-term influence of this approach on parents' integration of music postdischarge. Design: In this descriptive, observational within-subjects pilot cohort study, board-certified music therapists instructed and recorded mothers in singing selected songs of kin. Infants received the recorded sessions weekly from enrollment to discharge. Parents were surveyed at 1- and 6-year postdischarge. Sample: Medically stable preterm infants (n = 12) and their English-speaking parents (n = 17). Main Outcome Variable: Parent perceptions on participation and long-term influence on family integration of music during hospitalization and postdischarge. Results: Parents reported knowledge of soothing and interacting with their children as the highest benefit of MT. They also perceived the effects of an easier transition home, enhanced learning and child development, and personal benefits of positive mood and enhanced relaxation.
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Curley A, Jones LK, Staff L. Barriers to Couplet Care of the Infant Requiring Additional Care: Integrative Review. Healthcare (Basel) 2023; 11:healthcare11050737. [PMID: 36900743 PMCID: PMC10001342 DOI: 10.3390/healthcare11050737] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Historically, once the baby was born, the mother and baby were separated shortly after birth into a postnatal ward and a baby nursery. Overtime, with advances in neonatology led to an increasing number of neonates being separated from their mothers at birth for specialised neonatal care if they required additional needs. As more research has been undertaken there is an increasing focus that mothers and babies should be kept together from birth, termed couplet care. Couplet care refers to keeping the mother and baby together. Despite this evidence, in practice, this is not happening. AIM to examine the barriers to nurses and midwives providing couplet care of the infant requiring additional needs in postnatal and nursery. METHODS A thorough literature review relies on a well-developed search strategy. This resulted in a total of 20 papers that were included in this review. RESULTS This review revealed five main themes or barriers to nurses and midwives providing couplet care: models of care, systems and other barriers, safety, resistance, and education. DISCUSSION Resistance to couplet care was discussed as being caused by feelings of lack of confidence and competence, concerns around maternal and infant safety and an under-recognition of the benefits of couplet care. CONCLUSION The conclusion is that there is still a paucity of research in relation to nursing and midwifery barriers to couplet care. Although this review discusses barriers to couplet care, more specific original research on what nurses and midwives themselves perceive to be the barriers to couplet care in Australia is needed. The recommendation is therefore to undertake research into this area and interview nurses and midwives to ascertain their perspectives.
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McCulloch H, Campbell-Yeo M, Richardson B, Dol J, Hundert A, Dorling J, Whitehead L, MacRae G, Bishop T, Afifi J, Earle R, Rose AE, Foye S, Inglis D, Kim T, Leighton C, Melanson A, Simpson DC, Smit M. The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study. HERD 2021; 15:49-62. [PMID: 34931565 PMCID: PMC9072949 DOI: 10.1177/19375867211065178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.
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Affiliation(s)
| | - Marsha Campbell-Yeo
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Brianna Richardson
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Justine Dol
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | | | | | | | - Sarah Foye
- IWK Health, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | - Mike Smit
- School of Information Management, Dalhousie University, Halifax, Nova Scotia, Canada
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Murphy M, Shah V, Benzies K. Effectiveness of Alberta Family-Integrated Care on Neonatal Outcomes: A Cluster Randomized Controlled Trial. J Clin Med 2021; 10:jcm10245871. [PMID: 34945163 PMCID: PMC8708302 DOI: 10.3390/jcm10245871] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Family-Integrated Care (FICare) empowers parents to play an active role as a caregiver for their infant in the neonatal intensive care unit (NICU). This model of care is associated with improved neonatal outcomes, such as improved weight gain and higher breastfeeding rates at discharge in infants admitted to level III NICUs; however, its effectiveness in level II NICUs remains unproven. The objective of this study was to evaluate the effectiveness of the model on neonatal outcomes in a cluster randomized controlled trial conducted in 10 level II NICUs randomized to Alberta FICare or standard care. Mothers and their preterm infants born between 32+0 and 34+6 weeks' gestational age were included. The primary outcome was the proportion of infants who regained their birth weight (BW) after 14 days of life. The analysis included 353 infants/308 mothers at Alberta FICare sites and 365 infants/306 mothers at standard care sites. There was no difference in the proportion of infants who had regained their BW by 14 days between the groups. A lack of perceived improved weight gain trajectory for those in the FICare group is attributed to a shorter length of hospital stay and infants being discharged prior to regaining BW.
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Affiliation(s)
- Madeleine Murphy
- Department of Pediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (M.M.); (V.S.)
| | - Vibhuti Shah
- Department of Pediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (M.M.); (V.S.)
| | - Karen Benzies
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3300 University Drive NW, Calgary, AB T2N 4N1, Canada
- Correspondence:
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Camicia M, Lutz BJ, Stram D, Tucker LY, Ray C, Theodore BR. Improving Caregiver Health through Systematic Assessment and a Tailored Plan of Care. West J Nurs Res 2021; 44:307-318. [PMID: 34541990 DOI: 10.1177/01939459211045432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Caregivers often experience strain and negative effects on their well-being. We tested the effects of a caregiver assessment and tailored care plan for caregivers of patients transitioning home from an inpatient rehabilitation facility (IRF), a study involving two groups: usual care (n = 225) (preimplementation) and intervention (postimplementation) (n = 215). Caregivers in the intervention group were assessed using the 25-item self-reported Preparedness Assessment for the Transition Home during the IRF stay. A tailored care plan was implemented in response to the assessment. Caregivers in both groups completed the Modified Caregiver Strain Index and Global Health Scale at 30- and 90-day postdischarge. After adjusting for baseline and demographics, caregivers in the intervention group reported lower strain (p < .01) and better overall health (p < .05) at 30-day post-IRF discharge, relative to usual care. Implementing a systematic caregiver assessment and tailored care plan in the IRF may mitigate the adverse effects of caregiving.
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Affiliation(s)
- Michelle Camicia
- Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA
| | - Barbara J Lutz
- School of Nursing, University of North Carolina-Wilmington, Wilmington, NC, USA
| | - Douglas Stram
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Lue-Yen Tucker
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Cristine Ray
- Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA
| | - Brian R Theodore
- Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA
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Murdoch J, Hauck Y, Aydon L, Sharp M, Zimmer M. When can I hold my baby? An audit of time to first cuddle for preterm babies (<32 weeks) pre introduction and post introduction of a Family-Integrated Care model. J Clin Nurs 2021; 30:3481-3492. [PMID: 33982368 DOI: 10.1111/jocn.15850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/31/2020] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
AIM The audit examined time to first cuddle between preterm babies (born < 32 weeks) and their parent pre- and post-introduction of a family-integrated care model. Secondary outcomes included time to full feeds and length of neonatal intensive care stay. BACKGROUND Parental separation due to neonatal intensive care unit admission is known to negatively affect parental and baby wellbeing. DESIGN A "before-after" design compared outcomes for babies admitted pre- (2015) and post (2018)-implementation of the model in a Western Australian neonatal intensive care unit. METHODS A retrospective medical record audit included babies from two gestational age groups in 2015 and 2018, born ≤27 + 6 weeks and 28-31 + 6 weeks. SQUIRE checklist guided reporting of the audit. RESULTS One hundred fifty-three babies were included in the audit, 79 from 2015 (≤27 + 6 weeks n = 39 and 28-31 + 6 weeks n = 40) and 74 from 2018 (≤27 + 6 weeks n = 35 and 28-31 + 6 weeks n = 39). Babies in both years were born at similar median gestational ages with comparable birthweights. Babies born ≤27 + 6 weeks in 2018 were cuddled earlier (median = 141 h old) compared with those in 2015 (median = 157 h old). Median time to reach full feeds decreased and was significant in the ≤27 + 6-week group: 288 h (12 days) in 2015 to 207.5 h (8.6 days) in 2018. Length of stay was longer for the ≤27 + 6-week gestation 2018 group (median = 64 days) and 28-31 + 6-week gestation 2018 group (median = 22 days). CONCLUSION Family-integrated care models may decrease the time to first cuddle and full feeds. Further research on outcomes such as breastfeeding, infant weight gain and length of stay can extend existing knowledge. RELEVANCE TO CLINICAL PRACTICE Family-integrated care models may offer benefits to families of hospitalised preterm babies and investigating barriers to its implementation and creation of solutions to overcome barriers warrants attention.
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Affiliation(s)
- Jamee Murdoch
- Neonatal Directorate, Kind Edward Memorial Hospital, Subiaco & Perth Children's Hospital, CAHS, Nedlands, WA, Australia
| | - Yvonne Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Australia.,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Perth, WA, Australia
| | - Laurene Aydon
- Neonatal Directorate, Kind Edward Memorial Hospital, Subiaco & Perth Children's Hospital, CAHS, Nedlands, WA, Australia.,Department Nursing Research, Child and Adolescent Health Service, Nedlands, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
| | - Mary Sharp
- Neonatal Directorate, Kind Edward Memorial Hospital, Subiaco & Perth Children's Hospital, CAHS, Nedlands, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
| | - Margo Zimmer
- Department Nursing Research, Child and Adolescent Health Service, Nedlands, WA, Australia
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11
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Dahan S, Bourque CJ, Reichherzer M, Prince J, Mantha G, Savaria M, Janvier A. Peer support groups for families in Neonatology: Why and how to get started? Acta Paediatr 2020; 109:2525-2531. [PMID: 32304582 DOI: 10.1111/apa.15312] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/27/2020] [Accepted: 04/15/2020] [Indexed: 12/28/2022]
Abstract
AIM To describe the development of peer-to-peer support meetings between parents of children in neonatal intensive care unit (NICU) and veteran resource parents who had a previous NICU experience. METHODS The study had two steps: a needs assessment and a feasibility pilot study. Parental perspectives were investigated using mixed methods. RESULTS One hundred and fifty-three parents were participated. NICU parents (89%) wished to meet resource parents to discuss: their parental role, normalising their experience and emotions, adapting to their new reality, control, guilt, trust and coping. Practical aspects of the meetings were tested/finalised. Resource parent moderators reported that the presence of more than one moderator per meeting was essential. A checklist of topics to discuss was developed. Having a diversity of moderators (fathers, diagnoses other than prematurity, for example) was judged important. The name of the meeting had an impact on attendance: there were less participants when the word "support" was used. The best location (central, parents' kitchen) and optimal time/duration of meetings, selection of parent moderators and compensation were also determined. CONCLUSION Peer support meetings moderated by resource parents provide a unique and useful means to support NICU parents. Future investigations will explore whether these meetings will improve clinical outcomes.
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Affiliation(s)
- Sonia Dahan
- CHU Sainte‐Justine Research Center Montréal QC Canada
- Unité d'éthique clinique CHU Sainte‐Justine Montréal QC Canada
- Division of Neonatology CHU Sainte‐Justine Montréal QC Canada
| | - Claude Julie Bourque
- CHU Sainte‐Justine Research Center Montréal QC Canada
- Unité d'éthique clinique CHU Sainte‐Justine Montréal QC Canada
- Unité de recherche en éthique clinique et partenariat famille (UREPAF) Montréal QC Canada
- Department of Pediatrics Université de Montréal Montréal QC Canada
- Bureau de l'Éthique Clinique (BEC) Université de Montréal Montréal QC Canada
| | | | | | - Ginette Mantha
- Parent Representative Montréal QC Canada
- Préma‐Québec Association for Preterm Infants Longueuil QC Canada
| | - Melissa Savaria
- Division of Neonatology CHU Sainte‐Justine Montréal QC Canada
| | - Annie Janvier
- CHU Sainte‐Justine Research Center Montréal QC Canada
- Unité d'éthique clinique CHU Sainte‐Justine Montréal QC Canada
- Division of Neonatology CHU Sainte‐Justine Montréal QC Canada
- Unité de recherche en éthique clinique et partenariat famille (UREPAF) Montréal QC Canada
- Department of Pediatrics Université de Montréal Montréal QC Canada
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Mann D. Design, Implementation, and Early Outcome Indicators of a New Family-Integrated Neonatal Unit. Nurs Womens Health 2017; 20:158-66. [PMID: 27067932 DOI: 10.1016/j.nwh.2016.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/16/2015] [Indexed: 11/25/2022]
Abstract
Neonatal units are becoming more family-centered based on evidence of improved health outcomes when parents provide care to newborns. Physical environment constraints, as well as nursing care traditions and practices, have been barriers to providing care that includes close parental involvement. Our hospital's experience in implementing a unique model of family-centered care in a Level II nursery suggests that this model of care is beneficial to families, satisfying to health care providers, and a viable model for practice. Some basic outcome data are discussed along with suggestions for future research.
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Affiliation(s)
- Donna Mann
- Catholic Medical Center in Manchester, NH.
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