Background

In neonatology, survival rates of very-low-birth-weight infants are improving. Family-centered-care might be one of the contributing factors of infants’ clinical outcomes.

Objectives

To evaluate a parental education and participation in care intervention to improve clinical outcomes of very-low-birth-weight infants.

Methods

We conducted a quasi-experimental trial in a Chinese NICU from June 2016 to June 2017. The family-centered care intervention included parental education sessions of basic care following participation in care for minimal four hours a day. Totally, 319 very-low-birth-weight infants were recruited and assigned to the intervention group (n=156) and control group (n=163) by convenience sampling. Primary outcomes were weight at discharge, length-of-stay, breastfeeding, nasal feeding, total parental nutrition, hospital expenses. Secondary outcome measures were infants’ complications.

Results

Primary outcomes are presented in Table 1: Infants’ weight at discharge was higher in the interventions group (p<0.001). Nutritional outcomes improved significantly. Length-of-stay and hospital expenses did not differ between groups. Improved secondary outcomes were bronchopulmonary dysplasia (32vs51, p=0.031), retinopathy of prematurity (between groups no/mild and moderate/severe, p=0.003), necrotizing enterocolitis (6vs18, p=0.019), and re-admission rate (21vs38, p=0.023). No differences were observed in intraventricular hemorrhage and nosocomial infections.

Conclusion

Very-low-birth-weight premature infants might benefit from having parents as their primary caregivers. Infants might experience improved clinical outcomes when parents are caring from them for at least four hours a day. Family-centered care is a beneficial approach in neonatology and should be implemented by NICUs where parents have limited access or involvement in care.

Background

Approximately 10% of all births worldwide are preterm. These infants are often admitted at a Neonatal Intensive Care Unit (NICU). The NICU environment is very stressful for preterm infants and separation of the parents causes stress for both infant and parent. Family-Centered Care (FCC) is an approach of planning, delivery and evaluation of healthcare and based on a partnership between healthcare professionals and families of patients. Studies showed that parents of infants admitted to a unit with FCC approach were less stressed compared to parents at a Standard Care unit. Although FCC is beneficial to families and patients, implementation can be challenging. Therefore it is important that factors influencing the implementation of FFC are known.

Objectives

To explore factors that influence implementation of Family-Centered Care in a Neonatal Intensive Care Unit according to healthcare professionals that already work with Family-Centered Care in three different countries.

Methods

A descriptive generic qualitative design with semi-structured interviews and thematic analyses was used. This multi-center study was conducted in three hospitals in three countries: Sweden, Norway and The Netherlands.

Results

Seven neonatal care nurses, one nurse assistant, five neonatologists and three managers participated in this study. Four themes were identified: Behavioural change in staff, Family needs, Environment and Communication. Healthcare professionals described that the mindset of the professional influences the implementation of FCC.

Conclusion

Most important finding is the mindset of healthcare professionals in seeing parents as primary caregiver. This influences the way FCC is practiced and how parents are involved in the care for their infant.

Background

The setting of the current study is a capital city populated by a wide range of cultures, religions and degree of religiosity. This colorful array of population needs special considerations and empathetic care in PICU.

Objectives

Aim the aim of this study was to determine the influence of religions, religiosity and culture on parent satisfaction PICU.

Methods

The EMPATHIC-30 questionnaire was distributed PICU parents after admission. The questionnaire

was anonymous. This is a report of the interim analysis of 56 completed questionnaires; the expected sample size is 85 caretakers.

Results

The distribution of the sample population is 46% Jewish 50% Muslim and 4% Christian, 34% ultra religious, 45% religious 5% secular, 45% unplanned admissions which 36% were Jewish and 64% Arab. 53% population hospitalized longer than 1 week, 785 ventilated.

Significant difference between cultures (Jewish and Arabs) were found regarding daily physician and nurse talks with the parents, feeling welcome at admission and information about the (adverse) effects of the medication. Low satisfaction among all groups reflected daily scheduled meetings with treating physicians, knowing who is the attending physician

Conclusion

Areas needing improvement- both cultures need clarification who is the daily physician in charge. Future interventions are planned to improve daily scheduled talks with physicians, enhancing feelings of belonging by increasing multi-disciplinary meetings with parents. Inviting religious figures to visit families in crisis. A cultural competency-training program is planned to enhance knowledge and tools to nursing and physicians to better cope with our population.

Background

Skin to skin care (SSC) by mothers has been shown to be effective in providing pain relief. Often mother is not available to provide SSC and father provides it.

Objectives

To compare the pain control efficacy of skin to skin care given by mother and father by premature infant pain profile (PIPP) scale.

Methods

RCT involving stable preterm neonates (30 to 36 wk GA at birth) requiring heel-stick sampling. Study participants were randomly assigned in two groups. For participants in the group A, mother gave SSC starting 10 min prior to the procedure on 1 heel-stick and father gave SSC starting 10 min prior to the procedure on 2 heel-stick. For participants in the group B, father gave SSC on 1 heel-stick and mother gave SSC on 2 heel-stick. Analysis was done by descriptive statistics, independent sample t test and ANOVA.

Results

The study involved a total of 40 neonates. The mean (SD) BW,GA of neonates was 1600(351.7)gm and 34.15(2.3)wk. The mean(SD)PIPP scores for mother SSC group at 0,1,5 min were 3.2(1.2),7.7(4.2),3.7(1.5) respectively and in father SSC group, values at 0,1.5 min were 3.1(1.3),8.6(4.3),4.2(2.3) respectively. The difference between the PIPP score between the two groups was not significant (P values were 0.79 (0 min), 0.35(1 min) and 0.31(5 min)).

Conclusion

Pain reduction with skin to skin care by father is not significantly different as compared to that by mother. The trend of lower pain scores in skin to skin care by mother group will be further explored by a larger follow up trial.