Trends in care practices reflecting parental involvement in neonatal care
Simo Raiskila1, Anna Axelin2, Saara Rapeli1
1University of Turku, Finland.
Insights
Family-centered care practices in the Neonatal Intensive Care Unit improved parental involvement for very preterm infants. This shift correlated with significant improvements in infant weight gain during the study period.
Area of Science:
- Neonatal Intensive Care
- Pediatric Medicine
- Family-Centered Care
Background:
- Parental involvement is crucial for neonatal care outcomes.
- Everyday care practices significantly influence parental engagement in neonatal intensive care units (NICUs).
Purpose of the Study:
- To evaluate trends in family-centered care practices within the NICU at Turku University Hospital.
- To assess changes in parental involvement in neonatal care over time.
Main Methods:
- Retrospective chart review of very preterm infants across four cohorts (2001-2012).
- Evaluation of care practices including thermoregulation, nutrition, feeding, and skin-to-skin care episodes.
- Analysis of safety measures such as length of stay and weight gain at discharge.
Main Results:
- Significant decrease in gestational age at the end of incubator care and initiation of feeding methods.
- Earlier initiation of skin-to-skin care observed, particularly in infants born before 28 weeks.
- Weekly infant weight gain increased significantly from 110 g to 159 g.
Conclusions:
- Hospital care practices evolved to better support parental involvement for very preterm infants.
- Improved infant weight gain was observed concurrently with enhanced family-centered care practices.
- These evolving practices serve as indicators of progressive trends in family-centered neonatal care.
Background:
Everyday care practices can facilitate or hinder parents' participation and involvement in neonatal care.
Aims:
To evaluate trends in family-centered care practices in the Neonatal Intensive Care unit in Turku University Hospital.
Study Design And Subjects:
In this retrospective study, the patient charts of very preterm infants were reviewed in 4 cohorts: 2001 to 2002 (n=72), 2006 to 2007 (n=69), 2009 to 2010 (n=76), and 2011 to 2012 (n=78).
Outcome Measures:
Care practices with parental involvement were evaluated: 1) thermoregulation; 2) nutrition and feeding; 3) the beginning and number of skin-to-skin care episodes. As safety measures, the length of stay and weight gain were recorded at discharge.
Results:
The significant trends included: a decrease in gestational age at the end of incubator care (mean 33.4 [standard deviation (SD) 1.36] to 31.6 [SD 1.1], p<0.001) and at the beginning of breast-feeding (35.3 [SD 1.34] to 33.1 [SD 1.89], p<0.001), bottle feeding (from 34.1 [SD 1.04] to 33.3 [SD 1.51], p=0.003) and skin-to-skin care (from 32.8 [SD 1.99] to 29.9 [SD 2.34], p<0.001). The changes were most remarkable in the infants below 28 weeks. In addition, weight gain increased from 110 g to 159 g per week (p<0.001).
Conclusions:
The hospital care practices of very preterm infants developed during the study period support parental involvement. During the same time period, the weight gain of very preterm infants improved, significantly. These practices can serve as indicators of progressive trends in family centered care.
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