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Improving Family-Centered Care for Infants in Neonatal Intensive Care Units: Recommendations From Frontline
Linda S Franck1, Robin Bisgaard, Diana M Cormier
1Department of Family Health Care Nursing, University of California, San Francisco (Drs Franck and Gay); UCSF Benioff Children's Hospital, San Francisco, Intensive Care Nursery, San Francisco, California (Ms Bisgaard and Ms Lare); Community Regional Medical Center, Pediatric Services, Fresno, California (Dr Cormier); UCSF California Preterm Birth Initiative, University of California, San Francisco (Mss Hutchison and Kriz); UCSF Benioff Children's Hospital, Oakland, Intensive Care Nursery, Oakland, California (Mss Moore and Christensen); Intensive Care Nursery, Kaiser Permanente Santa Clara, Santa Clara, California (Ms Mora); UC San Diego Health, Jacobs Medical Center, La Jolla, California (Ms Ekno); and UCLA Health, Santa Monica Medical Center, Intensive Care Nursery Santa Monica, Los Angeles, California (Ms Hackett).
Background:
Family-centered care is a philosophy and healthcare delivery model adopted by many neonatal intensive care units (NICUs) worldwide, yet practice varies widely.
Purpose:
The aim of this study was to synthesize recommendations from frontline NICU healthcare professionals regarding family-centered care.
Methods:
Data were obtained from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care (baseline) with mobile-enhanced family integrated care (intervention). Members of the NICU clinical care team completed a family-centered care survey and provided free-text comments regarding practice of family-centered care in their NICU and recommendations for improvement. The comments were analyzed using a directed content analysis approach by a research team that included NICU nurses and parents.
Results:
Of the 382 NICU healthcare providers from 6 NICUs who completed the survey, 68 (18%) provided 89 free-text comments/recommendations about family-centered care. Almost all comments were provided by nurses (91%). Six main themes were identified: language translation; communication between staff and families; staffing and workflow; team culture and leadership; education; and NICU environment. The need for greater resources for staffing, education, and environmental supports was prominent among the comments, as was team culture and staff-parent communications.
Implications For Practice:
The NICU healthcare professionals identified a range of issues that support or impede delivery of family-centered care and provided actionable recommendations for improvement.
Implications For Research:
Future research should include economic analyses that will enable determination of the return on investment so that NICUs can better justify the human and capital resources needed to implement high-quality family-centered care.
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