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Impact of COVID-19-Related Restrictions on Parental Presence and Activities in the Neonatal Intensive Care Unit
Ryo Itoshima1,2,3, Arata Oda1,2, Toshimitsu Yanagisawa1,2
1Division of Neonatology, Nagano Children's Hospital, Azumino, Japan.
Insights
Alleviating neonatal intensive care unit (NICU) restrictions enhances parental presence and visit frequency. Less restrictive policies, like extended hours and allowing more family members, significantly increase how long parents stay and how often they visit preterm infants.
Area of Science:
- Neonatal Intensive Care Unit (NICU) Care
- Parental Engagement in Neonatal Health
- Public Health Policy and Family Well-being
Background:
- Neonatal intensive care units (NICUs) often implement visitor restrictions.
- Evaluating the impact of these restrictions on parental presence is crucial for infant care.
- This study focuses on the effects of varying restriction levels in a Japanese NICU.
Purpose of the Study:
- To assess how different NICU restriction measures influence parental presence duration and visit frequency.
- To compare the outcomes of three distinct restriction scenarios (R1, R2, R3).
- To provide evidence for optimizing NICU policies to support families.
Main Methods:
- Prospective cohort study in a level IV NICU (Japan, Feb 2021-Oct 2023).
- Included preterm infants (<35 weeks gestation).
- Compared three restriction levels: R1 (parents only, limited hours), R2 (parents + grandparents), R3 (extended visiting hours). Analyzed 4589 visits from 89 families using linear mixed models.
Main Results:
- Parental presence duration significantly increased from R1 to R2 and from R2 to R3.
- Visit frequency did not change between R1 and R2 but significantly increased from R2 to R3.
- The study analyzed data from 110 preterm infants across the three restriction groups.
Conclusions:
- Easing NICU restrictions positively impacts parental involvement.
- Extended visiting hours and broader family access can enhance parental presence and visit frequency.
- Findings suggest that less restrictive policies may improve the family-centered care environment in NICUs.
Background:
This study aimed to evaluate the impact of different restriction measures on parental presence and activities in a neonatal intensive care unit (NICU).
Methods:
A prospective cohort study was conducted in a level IV NICU in Japan between February 2021 and October 2023. The study included preterm infants born at < 35 weeks of gestation. Study groups included three different restriction measures: R1, only parents could visit the NICU between 9 a.m. and 3 p.m.; R2, grandparents and parents were allowed; and R3, visiting hours were extended to between 7 a.m. and 9 p.m. Primary outcomes were duration of parental presence (minutes per visit) and visiting frequency (days per week). Linear mixed models were used to adjust for potential confounders and to account for each family.
Results:
We analyzed 4589 visits made by 89 families of 110 preterm infants. There were 69, 33, and 24 infants in the R1, R2, and R3 groups, respectively. In a linear mixed model, duration of at least one of the parents' presence in the NICU (mean difference [95% confidence interval]) was significantly longer in the R2 group than that in the R1 group (54.9 [36.9-68.5] min), and also in the R3 group than that in the R2 group (28.4 [9.3-45.8] min). Additionally, the frequency of parental visits to the NICU per week did not change between R1 and R2, but it increased significantly between R2 and R3 (0.5 [0.1-0.9]).
Conclusions:
Alleviating restrictive measures in NICUs may increase parental presence and visit frequency.
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