A global view of competency in neonatal care

Understanding parents' emotional experiences for neonatal education: A narrative, interpretive approach

AIMS AND OBJECTIVES

To explore the emotional experiences of parents who have had premature babies to inform and educate neonatal nurses and health professionals in this field.

BACKGROUND

Parents find the neonatal unit a daunting and unfamiliar place leading to anxiety, uncertainty and fear about the future of their baby. Parents have significant emotional needs in relation to assisting them to cope with their neonatal experience. In line with a family-centred approach to neonatal education, it is essential to teach health professionals about the emotional impact of neonatal care based on an appreciation of the parent experience.

DESIGN

A narrative-based, interpretive approach was undertaken in line with constructivist learning theory.

METHODS

Twenty narrative interviews took place, with a total of 23 parents of premature babies. Following core story creation to create coherent stories from the raw transcripts, thematic analysis of the narrative constructs using the principles of Braun and Clarke's, International Journal of Qualitative Studies on Health and Well-Being, 2014, 9, 1, framework was undertaken. The study methods were compliant with the consolidated criteria for reporting qualitative research (COREQ).

FINDINGS

Thematic analysis revealed key themes relating to the following: parents' emotions through the whole neonatal experience, feelings towards the baby, the environment, the staff and the transitions through the different phases of neonatal care. Both negative and positive experiences were reported.

CONCLUSION

Understanding the emotional experience from the parent's perspective, following birth of their premature baby, informs empathic, family-centred teaching and learning within the neonatal education arena.

RELEVANCE TO CLINICAL PRACTICE

Students and health professionals alike can learn what is important in the delivery of care that addresses the emotional needs of parents and families. Educators can use narratives and key messages from parents, both negative and positive, to teach family-centred principles to nurses and health professionals as a core component of a narrative curricula and potentially to enhance empathy.

Human factors considerations in designing for infection prevention and control in neonatal care - findings from a pre-design inquiry

Qualitative data collection methods drawn from the early stages of human-centred design frameworks combined with thematic analysis were used to develop an understanding of infection prevention practice within an existing neonatal intensive care unit. Findings were used to generate a framework of understanding which in turn helped inform a baseline approach for future research and design development. The study revealed that a lack of clarity between infection transmission zones and a lack of design attributes needed to uphold infection prevention measures may be undermining healthcare workers' understanding and application of good practice. The issue may be further complicated by well-intentioned behavioural attitudes to meeting work objectives; undue influences from spatial constraints; the influence of inadvertent and excessive touch-based interactions; physical and/or cognitive exertion to maintain transmission barriers; and the impact of expanding job design and increased workload to supplement for lack of effective barriers. Practitioner Summary: Despite high hand hygiene compliance within a neonatal intensive care unit, healthcare workers expressed concerns about the unit design and infection prevention practice. Early inquiry methods from human-centred design and thematic analysis helped develop a framework to understand how design can be used to aid infection prevention.

A qualitative descriptive exploration of the educational and career plans of early career neonatal nurses and midwives: An Irish perspective

The scarcity of appropriately qualified nurses and midwives is a major obstacle in achieving an effective health system. Neonatal nurses and midwives require a high level of skill and education to fulfil their role. It is also an area that sees high staff turnover rates. For this study a descriptive qualitative approach was used to ascertain early career neonatal nurses' and midwives' experiences of further education, their future career plans, and their perceived facilitators and barriers to further education and career progression. After receiving ethical approval, twelve nurses and midwives were recruited across three tertiary level neonatal units in Ireland. Semi structured interviews were carried out and interview transcripts were subsequently analysed using Attride-Stirling's (2001) Thematic Networks to deduce themes from the data. Support and involvement, mentoring, and career progression and retention were the three main themes identified upon analysis of the data. The majority of participants identified definitive career plans but some felt their goals were unachievable in their current workplace. Consequently a large number of participants have plans to leave their employment in neonates and pursue a career in other areas of nursing. Staff appraisals and succession planning programmes may assist early career nurses and midwives in focusing on their individual career goals, leading to a greater uptake of further specialised education and improved retention of neonatal nurses and midwives.

Spanish Validation of the Premie-Neuro Scale in Premature Infants

This study was an observational cross-validation of a Spanish version of the Premie-Neuro, a neurological examination for preterm infants. A cross-cultural translation was used to generate a Spanish version of the scale. The results showed an internal consistency of 0.72 according to Cronbach's alpha coefficient. The intra-class coefficient of correlation for the overall scores was 0.78. Factor analysis provided evidence of construct validity. The Spanish version of the Premie-Neuro was found to be a reliable and valid instrument for evaluating neurological and physical statements for premature infants admitted to a neonatal intensive care unit.