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What Counts as a NICU Family Meeting?: A Qualitative Study of Parent and Professional Perspectives
Animesh Sabnis1, Amanda McArthur, Eunice Hagen
1Author Affiliations: Department of Pediatrics, David Geffen School of Medicine (DGSOM), University of California, Los Angeles (UCLA), Los Angeles, California (Dr Sabnis); Office of Health Equity and Inclusive Excellence, UCLA Health System, Los Angeles, California (Dr Sabnis); Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (Dr McArthur); Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (Dr Hagen); Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Ms Fojo); UCLA Santa Monica Medical Center, Intensive Care Nursery, UCLA Health, Santa Monica, Los Angeles, California (Ms Hackett); and Department of Family Medicine, DGSOM, UCLA, Los Angeles, California (Dr Tarn).
Background:
Interdisciplinary family meetings reduce parental traumatic stress and promote shared decisions in the neonatal intensive care unit (NICU). Existing definitions of family meetings derive from adult studies. NICUs need NICU-specific criteria reflecting their distinct clinical and psychosocial context.
Purpose:
To identify NICU parent and clinician values and expectations about the structure and functions of family meetings to develop a NICU-specific definition and checklist for quantifying neonatal family meetings.
Methods:
Qualitative thematic analysis of semi-structured interviews with parents and clinical professionals recruited from an academic, quaternary-care NICU.
Results:
Thirteen parents and 25 professionals (16 nurses, 7 neonatologists, 2 social workers) defined a NICU family meeting as a seated, serious conversation in a private room involving a patient's parents, nurse, and neonatologist. This definition translated to a checklist capturing meeting location and participants. Participants differentiated "meetings" ("serious" conversations needed when parents and professionals lack a shared understanding of the child's condition) from "updates" ("general" parent-professional conversations). Participants identified logistical and cultural barriers to holding crucial meetings and generated solutions.
Implications For Practice:
This study identified nurse presence and participation as essential for serious conversations with NICU families. Nursing and hospital leaders can implement the resultant NICU-centered definition and checklist for neonatal family meetings into health informatic systems to promote parent-professional communication and to prospectively monitor unit-wide family-centered care.
Implications For Research:
Future research should validate the checklist across diverse NICUs, assess its impact on family outcomes, and identify solutions to barriers limiting nurse participation in family meetings.
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