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Neonatal family-centered care in a pandemic
Brian S Carter1,2,3, Tiffany Willis4,5, Angela Knackstedt6
1Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA. bscarter@cmh.edu.
Insights
Family-centered care (FCC) in Neonatal ICUs has been challenged by COVID-19 policies, disrupting clinician-parent collaboration. Rebuilding FCC is essential to support families and reduce NICU staff moral distress.
Area of Science:
- Neonatal care
- Pediatric healthcare
- Healthcare policy
Background:
- Family-centered care (FCC) is standard in North American Neonatal Intensive Care Units (NICUs).
- FCC has fostered clinician-parent collaboration and shaped hospital culture for 25 years.
- The COVID-19 pandemic introduced challenges to FCC implementation.
Purpose of the Study:
- To review the disruption of FCC principles during the COVID-19 pandemic.
- To identify the impact of restrictive policies on clinician-parent collaboration and family well-being.
- To outline the necessary steps for rebuilding FCC.
Main Methods:
- This is a perspective piece.
- It reviews the characteristics of FCC that have been disrupted.
- It discusses the facets required for rebuilding FCC.
Main Results:
- COVID-19 visitor policies limited parental presence, hindering bonding and causing stress.
- Difficult access and inconsistent information negatively impacted families.
- NICU staff experienced moral distress due to these disruptions.
Conclusions:
- The pandemic has challenged established FCC practices.
- Rebuilding FCC requires addressing parental access, communication, and staff support.
- Restoring FCC is crucial for optimal infant, family, and staff outcomes.
Abstract:
Family-centered care (FCC) has become the normative practice in Neonatal ICUs across North America. Over the past 25 years, it has grown to impact clinician-parent collaborations broadly within children's hospitals as well as in the NICU and shaped their very culture. In the current COVID-19 pandemic, the gains made over the past decades have been challenged by "visitor" policies that have been implemented, making it difficult in many instances for more than one parent to be present and truly incorporated as members of their baby's team. Difficult access, interrupted bonding, and confusing messaging and information about what to expect for their newborn can still cause them stress. Similarly, NICU staff have experienced moral distress. In this perspective piece, we review those characteristics of FCC that have been disrupted or lost, and the many facets of rebuilding that are presently required.
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