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Updated: Jun 27, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Collaborative Recognition of Wellbeing Needs: A Novel Approach to Universal Psychosocial Screening on the Neonatal
Davy Evans1,2, Daisy Eatwell3, Shevonne Hodson-Walker3
1Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK. davy.evans@nhs.net.
Insights
Implementing universal psychological needs screening for neonatal care families in the UK significantly increased access to psychological interventions. This quality improvement project highlights the need for workforce capacity to support such programs.
Area of Science:
- Neonatal Intensive Care
- Psychological Support
- Quality Improvement
Background:
- International recommendations for universal psychological needs screening in neonatal care are not routinely practiced in the UK.
- Neonatal intensive care units (NICUs) present unique challenges for identifying and addressing family psychological needs.
- Existing practices may not adequately capture the psychological distress experienced by families with infants in NICU.
Purpose of the Study:
- To explore the clinical and operational feasibility of a novel universal screening approach for psychological needs in a UK NICU.
- To implement and evaluate a strengths-based, collaborative screening method for families with infants in neonatal care.
- To assess the impact of universal screening on access to psychological interventions.
Main Methods:
- A quality improvement project was conducted on a UK NICU.
- A novel screening tool, co-developed with families, was utilized.
- Screening occurred at admission, transition, or discharge over a one-month period, involving 42 of 80 eligible families.
Main Results:
- Screening completion rates were higher at admission compared to discharge.
- The novel screening protocol led to an eightfold increase in families accessing psychological interventions.
- Feasibility was demonstrated, but workforce capacity emerged as a critical factor.
Conclusions:
- Universal psychological screening is operationally feasible in a UK NICU setting.
- This approach significantly enhances access to necessary psychological support for families.
- Adequate workforce capacity is essential for successful implementation and response to identified needs.
Abstract:
Universal screening for the psychological needs of families in neonatal care is internationally recommended, but is not routinely practiced in the United Kingdom (UK). The present quality improvement project explores the clinical and operational feasibility of a novel approach to universal screening on a neonatal intensive care unit in the UK. The approach to screening taken adopts collaborative, strengths-based and dialogical methods for recognising the psychological needs of families whose baby is in hospital. A novel screening tool, developed through consultation with families, is described. Over one month, 42 out of 80 eligible families engaged with the screening protocol either at admission to the unit, transition to the special care nursery within the unit, or discharge home, with completion rates higher at admission than discharge. This led to an eightfold increase in the number of families accessing targeted or specialist psychological intervention compared to the period prior to this pilot. This project demonstrates the need for adequate capacity in the workforce to carry out a screening programme and to respond to the needs identified.
