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Parental presence on neonatal intensive care unit clinical bedside rounds: randomised trial and focus group
Mohamed E Abdel-Latif1, Danette Boswell2, Margaret Broom2
1Department of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Woden, Australian Capital Territory, Australia School of Clinical Medicine, Australian National University, Woden, Australian Capital Territory, Australia.
Insights
Parental presence at clinical bedside rounds (PPCBR) in neonatal intensive care units (NICUs) is strongly supported by parents and healthcare providers. NICUs should implement policies for PPCBR, addressing potential concerns.
Area of Science:
- Neonatal Intensive Care Unit (NICU) care practices
- Clinical trial methodology in pediatrics
- Parental involvement in healthcare
Background:
- Limited data exist on parental presence at clinical bedside rounds (PPCBR) versus non-PPCBR in neonatal intensive care units (NICUs).
- Understanding parental and healthcare provider perspectives is crucial for optimizing NICU care delivery.
Purpose of the Study:
- To evaluate parental and healthcare provider support for PPCBR in NICUs.
- To compare parental stress and satisfaction between PPCBR and non-PPCBR settings.
- To identify benefits and challenges associated with PPCBR.
Main Methods:
- A single-centre, survey-based, crossed-over randomised trial was conducted with parents of infants in the NICU.
- Parents were randomized to PPCBR or non-PPCBR, then crossed over after a wash-out period.
- Validated tools (NICU Parental Stressor Scale) and satisfaction surveys were administered; healthcare providers were also surveyed and interviewed.
Main Results:
- A high percentage of parents (95%) and healthcare providers (90%) supported parental attendance at bedside rounds.
- Qualitative data from focus groups highlighted the benefits of PPCBR.
- The study enrolled 72 parents, with 63 completing the trial.
Conclusions:
- Both parents and healthcare providers strongly advocate for PPCBR in NICUs.
- NICUs should establish policies enabling PPCBR, while actively addressing concerns like education and confidentiality.
Background:
There are limited data to inform the choice between parental presence at clinical bedside rounds (PPCBR) and non-PPCBR in neonatal intensive care units (NICUs).
Methods:
We performed a single-centre, survey-based, crossed-over randomised trial involving parents of all infants who were admitted to NICU and anticipated to stay >11 days. Parents were randomly assigned using a computer-generated stratified block randomisation protocol to start with PPCBR or non-PPCBR and then crossed over to the other arm after a wash-out period. At the conclusion of each arm, parents completed the 'NICU Parental Stressor Scale' (a validated tool) and a satisfaction survey. After completion of the trial, we surveyed all healthcare providers who participated at least in one PPCBR rounding episode. We also offered all participating parents and healthcare providers the opportunity to partake in a focus group discussion regarding PPCBR.
Results:
A total of 72 parents were enrolled in this study, with 63 parents (87%) partially or fully completing the trial. Of the parents who completed the trial, 95% agreed that parents should be allowed to attend clinical bedside rounds. A total of 39 healthcare providers' surveys were returned and 35 (90%) agreed that parents should be allowed to attend rounds. Nine healthcare providers and 8 parents participated in an interview or focus group, augmenting our understanding of the ways in which PPCBR was beneficial.
Conclusions:
Parents and healthcare providers strongly support PPCBR. NICUs should develop policies allowing PPCBR while mitigating the downsides and concerns of parents and healthcare providers such as decreased education opportunity and confidentiality concerns.
Trial Registration Number:
Australia and New Zealand Clinical Trials Register number, ACTRN12612000506897.
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