Improving Involvement of Families of Small Babies through Family Education, Family Integration, and Multidisciplinary
Kris Nicole D Mendoza1, Hyacinth Lewis1, Lynsey Garver1
1From the Division of Neonatology, Department of Pediatrics, University of Rochester, Rochester, N.Y.
Insights
Family-centered care conferences (FCCC) in the neonatal intensive care unit (NICU) improved family involvement in infant care. Further interventions are needed to reach the target participation rates for better infant neurodevelopment and family support.
Area of Science:
- Neonatal Intensive Care Unit (NICU) care
- Family-centered care interventions
- Infant neurodevelopment
Background:
- Family-centered care is crucial for infant neurodevelopment, parent well-being, and family support in the NICU.
- Early family integration in neonatal care leads to improved short-term and long-term outcomes.
Purpose of the Study:
- To increase family participation in multidisciplinary family-centered care conferences (FCCC) for infants born at <28 weeks gestation or <1000g from 0% to 50%.
- To increase family attendance at the first NICU follow-up clinic from 74% to 90%.
Main Methods:
- Utilized the model for improvement with plan-do-study-act cycles for iterative interventions.
- FCCCs focused on bedside involvement, infant neurodevelopment, skin-to-skin care, family support, and care transitions.
- Outcome, process, and balancing measures were tracked using statistical process control charts.
Main Results:
- Within 18 months, family participation in FCCC increased from 0% to 39% (48/123 infants).
- Post-FCCC surveys indicated families found the conferences helpful for understanding their role in infant care.
- Families expressed interest in a second FCCC focused on preparing for home transition.
Conclusions:
- Family participation in FCCC increased but did not meet the initial goal.
- Continued plan-do-study-act cycles are anticipated to enhance adherence to the FCCC program.
- Integrating families into infant care during critical developmental stages is key for optimal outcomes.
Introduction:
Partnering with and educating families in the neonatal intensive care unit (NICU) is critical for infant neurodevelopment, parent wellness, and family support. Early family integration in care improves both short-term and long-term outcomes. This quality improvement project has 2 specific aims: (1) increase the percentage of small babies (born at <28 wk of gestation or <1000 g) whose families participated in a multidisciplinary family-centered care conference (FCCC) from 0% to 50%, and (2) increase family attendance at the first NICU follow-up clinic from 74% to 90%.
Methods:
Using the model for improvement, we conducted plan-do-study-act cycles with iterative interventions to achieve our aims. The FCCCs focused on promoting family involvement at the bedside, infant neurodevelopment, skin-to-skin care, family support, and transitions within the NICU and after discharge. Outcome, process, and balancing measures were tracked and analyzed for special cause variation using statistical process control charts.
Results:
Within 18 months, the percentage of infants whose families participated in an FCCC increased from 0% to 39% (48/123). Based on the post-FCCC survey, families found the FCCC helpful in providing information on how they can be involved in their infant's care. They recommended the FCCC to other families, and they expressed interest in a second FCCC focused on preparing for the transition home.
Conclusions:
Family participation in a multidisciplinary FCCC increased over time but has not yet achieved the stated goal. We anticipate that further plan-do-study-act cycles will improve adherence to a robust FCCC program by integrating families into their infants' care during critical developmental stages.
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