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Urbina T, Balasundaram M, Coughlin M, Sorrells K, Toney-Noland C, Day C. The Why and How of Family-Centered Care. Neoreviews 2024; 25:e393-e400. [PMID: 38945966 DOI: 10.1542/neo.25-7-e393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 07/02/2024]
Abstract
Although the Accreditation Council for Graduate Medical Education states that neonatal-perinatal medicine fellows must demonstrate an understanding of the emotional impact of admission to the NICU on a family, few curricula are in place to teach this important competency. Family-centered care (FCC) in the NICU is an approach to health care that focuses on decreasing mental and emotional trauma for families while empowering them to reclaim their role as caregivers. FCC is deeply rooted in trauma-informed care and is crucial during transition periods throughout the NICU admission. In this article, we provide a review of FCC and trauma-informed care and how to use these approaches at different stages during an infant's hospitalization. We also discuss parent support networks and how to integrate FCC into an existing NICU practice.
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Affiliation(s)
- Theresa Urbina
- Department of Pediatrics, Uniformed Services University of Health Services, Bethesda, MD
| | - Malathi Balasundaram
- Division of Neonatology, Department of Pediatrics, Stanford Medicine Children's Health, Standford, CA
| | | | | | | | - Colby Day
- Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
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2
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van de Riet L, Alsem MW, van der Leest EC, van Etten-Jamaludin FS, Maaskant JM, van Woensel JBM, van Karnebeek CD. Delineating family needs in the transition from hospital to home for children with medical complexity: part 1, a meta-aggregation of qualitative studies. Orphanet J Rare Dis 2023; 18:386. [PMID: 38082309 PMCID: PMC10714518 DOI: 10.1186/s13023-023-02942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Advances in diagnostic and therapeutic interventions for rare diseases result in greater survival rates, with on the flipside an expanding group of children with medical complexity (CMC). When CMC leave the protective hospital environment to be cared for at home, their parents face many challenges as they take on a new role, that of caregiver rather than care-recipient. However, an overview of needs and experiences of parents of CMC during transition from hospital-to-home (H2H) is lacking, which hampers the creation of a tailored H2H care pathway. Here we address this unmet medical need by performing a literature review to systematically identify, assess and synthesize all existing qualitative evidence on H2H transition needs of CMC parents. METHODS An extensive search in Medline, PsychINFO and CINAHL (up to September 2022); selection was performed to include all qualitative studies describing parental needs and experiences during H2H transition of CMC. All papers were assessed by two independent investigators for methodological quality before data (study findings) were extracted and pooled. A meta-aggregation method categorized the study findings into categories and formulated overarching synthesized findings, which were assigned a level of confidence, following the ConQual approach. RESULTS The search yielded 1880 papers of which 25 met eligible criteria. A total of 402 study findings were extracted from the included studies and subsequently aggregated into 50 categories and 9 synthesized findings: (1) parental empowerment: shifting from care recipient to caregiver (2) coordination of care (3) communication and information (4) training skills (5) preparation for discharge (6) access to resources and support system (7) emotional experiences: fatigue, fear, isolation and guilt (8) parent-professional relationship (9) changing perspective: finding new routines and practices. The overall ConQual Score was low for 7 synthesized findings and very low for 2 synthesized findings. CONCLUSIONS Despite the variability in CMC symptoms and underlying (rare disease) diagnoses, overarching themes in parental needs during H2H transition emerged. We will augment this new knowledge with an interview study in the Dutch setting to ultimately translate into an evidence-based tailored care pathway for implementation by our interdisciplinary team in the newly established 'Jeroen Pit Huis', an innovative care unit which aims for a safe and sustainable H2H transition for CMC and their families.
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Affiliation(s)
- L van de Riet
- Department of Pediatric Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - M W Alsem
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - E C van der Leest
- Department of Pediatric Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - F S van Etten-Jamaludin
- Medical Library AMC, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J M Maaskant
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J B M van Woensel
- Department of Pediatric Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - C D van Karnebeek
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands.
- Emma Center for Personalized Medicine, Departments of Pediatrics and Human Genetics, Amsterdam Gastro-Enterology Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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3
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Feng H, Liu Y, Li J, Jiang H. Breastfeeding-oriented education for parturients separated from their hospitalized infants: a qualitative study of nurses' perspectives in Shanghai, China. BMC Pregnancy Childbirth 2022; 22:888. [PMID: 36456913 PMCID: PMC9713735 DOI: 10.1186/s12884-022-05227-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The benefits of breastfeeding for both mother and baby are well recognized. However, the separation of the mother-newborn dyad leads to a lower breastfeeding rate. These parturients who are separated from their hospitalized infants are sometimes unaware of the importance of breastfeeding, while nurses do know how important health education on breastfeeding is and how it can be improved. This descriptive qualitative study aimed to explore the experiences of nurses regarding health education on breastfeeding and summarize the potential ways to improve it. METHODS A descriptive phenomenological qualitative approach was utilized in this study, and in-depth, semi-structured interviews were conducted with nurses at a tertiary A-grade obstetrics-and gynecology-specialized hospital in Shanghai, China. The purposive and snowball sampling method was used and Colaizzi's seven-step phenomenological analysis was employed. The Consolidated criteria for Reporting Qualitative research (COREQ) was followed to report findings. RESULTS Fifteen nurses participated in the study and shared their suggestions based on their experiences. Four overarching themes emerged from the data: (1) extending the education duration, (2) enriching the educational content, (3) expanding the education subjects, and (4) perfecting the educational process. Each theme included several subthemes. CONCLUSION Health education on breastfeeding should focus on the time, content, subjects, and process as a whole. The nurses' statements provided a reference for nursing or hospital supervisors to take measures to improve education and increase the breastfeeding rate of hospitalized neonates. Further research from the perspectives of parturients and their family members is needed, to find out what the key points are that all of them attach importance to.
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Affiliation(s)
- Haoxue Feng
- grid.24516.340000000123704535Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092 China
| | - Ying Liu
- grid.459512.eObstetrics Department, Shanghai First Maternity and Infant Hospital, Shanghai, 201204 China
| | - Junying Li
- grid.459512.eGynecology Department, Shanghai First Maternity and Infant Hospital, Shanghai, 201204 China
| | - Hui Jiang
- grid.459512.eNursing Department, Shanghai First Maternity and Infant Hospital, Shanghai, 201204 China
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Increasing Parent Satisfaction With Discharge Planning: An Improvement Project Using Technology in a Level 3 NICU. Adv Neonatal Care 2022; 22:108-118. [PMID: 33534225 PMCID: PMC8983942 DOI: 10.1097/anc.0000000000000841] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neonatal intensive care unit (NICU) families are often overwhelmed by the discharge process. Their anxiety can inhibit learning and contribute to poor infant outcomes and increased healthcare utilization after discharge. Quality of the discharge teaching is the strongest predictor of discharge readiness, so NICUs must develop excellent discharge preparation programs. PURPOSE This improvement project enhances NICU discharge preparedness by providing consistent, early discharge teaching using technology as a supplemental resource and raises parental satisfaction with the process. METHODS Neonatal intensive care unit staff and former NICU parents developed a task force to create technology-based discharge education content. The content was originally uploaded to an e-book and later transferred to the electronic health record inpatient portal. Families were able to view discharge teaching content at their own convenience and pace and review topics as needed with the NICU staff. Postdischarge follow-up phone calls provided insight into parental reaction to the new education format. RESULTS Parent satisfaction top-box scores, reflecting the highest rating in the "Prepared for Discharge" category of the patient satisfaction survey, improved from a baseline of 47% in 2017 to 70% in 2019. Overwhelmingly, 92% of families highly rated the tablet-based discharge teaching during postdischarge phone calls. IMPLICATIONS FOR PRACTICE A comprehensive, consistent, and early discharge program using technology can lead to more effective and efficient NICU discharge education and improved parent satisfaction. IMPLICATIONS FOR RESEARCH Further studies are needed to generalize hospital-based inpatient portal teaching as an additional resource for parental education in the NICU.
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Rosgen BK, Plotnikoff KM, Krewulak KD, Shahid A, Hernandez L, Sept BG, Morrissey J, Robertson K, Fraser N, Niven DJ, Straus SE, Leigh JP, Stelfox HT, Fiest KM. Co-development of a transitions in care bundle for patient transitions from the intensive care unit: a mixed-methods analysis of a stakeholder consensus meeting. BMC Health Serv Res 2022; 22:10. [PMID: 34974832 PMCID: PMC8722038 DOI: 10.1186/s12913-021-07392-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Intensive care unit (ICU) patients undergoing transitions in care are at increased risk of adverse events and gaps in medical care. We evaluated existing patient- and family-centered transitions in care tools and identified facilitators, barriers, and implementation considerations for the application of a transitions in care bundle in critically ill adults (i.e., a collection of evidence-based patient- and family-centred tools to improve outcomes during and after transitions from the intensive care unit [ICU] to hospital ward or community). Methods We conducted a concurrent mixed methods (quan + QUAL) study, including stakeholders with experience in ICU transitions in care (i.e., patient/family partners, researchers, decision-makers, providers, and other knowledge-users). First, participants scored existing transitions in care tools using the modified Appraisal of Guidelines, Research and Evaluation (AGREE-II) framework. Transitions in care tools were discussed by stakeholders and either accepted, accepted with modifications, or rejected if consensus was achieved (≥70% agreement). We summarized quantitative results using frequencies and medians. Second, we conducted a qualitative analysis of participant discussions using grounded theory principles to elicit factors influencing AGREE-II scores, and to identify barriers, facilitators, and implementation considerations for the application of a transitions in care bundle. Results Twenty-nine stakeholders attended. Of 18 transitions in care tools evaluated, seven (39%) tools were accepted with modifications, one (6%) tool was rejected, and consensus was not reached for ten (55%) tools. Qualitative analysis found that participants’ AGREE-II rankings were influenced by: 1) language (e.g., inclusive, balance of jargon and lay language); 2) if the tool was comprehensive (i.e., could stand alone); 3) if the tool could be individualized for each patient; 4) impact to clinical workflow; and 5) how the tool was presented (e.g., brochure, video). Participants discussed implementation considerations for a patient- and family-centered transitions in care bundle: 1) delivery (e.g., tool format and timing); 2) continuity (e.g., follow-up after ICU discharge); and 3) continuous evaluation and improvement (e.g., frequency of tool use). Participants discussed existing facilitators (e.g., collaboration and co-design) and barriers (e.g., health system capacity) that would impact application of a transitions in care bundle. Conclusions Findings will inform future research to develop a transitions in care bundle for transitions from the ICU, co-designed with patients, families, providers, researchers, decision-makers, and knowledge-users. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07392-2.
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Affiliation(s)
- Brianna K Rosgen
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,Department of Community Health Sciences, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Kara M Plotnikoff
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Karla D Krewulak
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Anmol Shahid
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Laura Hernandez
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Bonnie G Sept
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Jeanna Morrissey
- Critical Care Strategic Clinical Network, Alberta Health Services, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada
| | - Kristin Robertson
- Critical Care Strategic Clinical Network, Alberta Health Services, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada
| | - Nancy Fraser
- Critical Care Strategic Clinical Network, Alberta Health Services, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada
| | - Daniel J Niven
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,Critical Care Strategic Clinical Network, Alberta Health Services, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada
| | - Sharon E Straus
- Department of Medicine, Institute for Health Policy, Management and Evaluation, University of Toronto, 1 King's College Cir, Toronto, ON, M5S 1A8, Canada
| | - Jeanna Parsons Leigh
- Department of Medicine, School of Health Administration, Dalhousie University, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,Critical Care Strategic Clinical Network, Alberta Health Services, 10030 - 107 Street NW, Edmonton, AB, T5J 3E4, Canada.,O'Brien Institute for Public Health, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, 3260 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada. .,Department of Community Health Sciences, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada. .,O'Brien Institute for Public Health, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada. .,Department of Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
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6
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Improving the Efficiency and Effectiveness of Parent Education in the Neonatal Intensive Care Unit. Adv Neonatal Care 2020; 20:59-67. [PMID: 31246617 PMCID: PMC7004457 DOI: 10.1097/anc.0000000000000644] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: March of Dimes partners with hospitals across the country to implement NICU Family Support (NFS) Core Curriculum, a program providing education to parents in neonatal intensive care units (NICUs) across the country. Purpose: This NFS project's goal was to increase the efficiency and effectiveness of NICU parent education by establishing consistency, improving quality, and identifying best practices. Methods/Search Strategy: A 5 topic curriculum was developed and implemented across NFS program sites. The project studied 4 main outcomes of interest related to efficiency and effectiveness: increase in parenting confidence, parent learning, knowledge change, and satisfaction. Data were collected from speakers and attendees immediately following educational sessions. Analytical approaches included descriptive statistics such as frequency, percentage, and response rate, and inferential approaches such as t test, χ2, and analysis of variance. Findings/Results: Findings suggest that the NFS Core Curriculum improved both program efficiency and effectiveness. Sessions fully implemented according to recommended strategies had better outcomes than sessions not fully implemented according to recommended strategies (P < .0001). Across the 3648 attendees at 41 sites, 77% of parents reported learning “a lot” at the session they attended and 85% of attendees reported increased confidence. Attendees also reported positive knowledge change and high satisfaction. Implications for Practice: Parent education best practices identified through this initiative can be utilized for future NFS Core Curriculum topics and potentially generalized to all NICU parent education and family education in other hospital intensive care units. Implications for Research: Content and best practices identified through this project will require regular review to ensure medical accuracy and appropriateness of best practices as the physical design of NICUs evolves.
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Benscoter D, Borschuk A, Hart C, Voos K. Preparing families to care for ventilated infants at home. Semin Fetal Neonatal Med 2019; 24:101042. [PMID: 31648918 DOI: 10.1016/j.siny.2019.101042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Advances in neonatal care have led to increased survival of infants with complex medical needs and technology dependence. Transition of the ventilator-dependent infant from hospital to home is a complex process that requires extensive coordination between the medical team and family. Home caregivers must be prepared to provide routine care for the ventilator-dependent child and respond to life-threatening emergencies. Families should be counseled on the need for home nursing, medical equipment and an adequate home environment to ensure a safe transition to home. Throughout the process, the family may require financial, social and psychological support. A structured education and transition process that is clearly communicated to parents is necessary to have an effective partnership with families.
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Affiliation(s)
- Dan Benscoter
- Department of Pediatrics, University of Cincinnati, College of Medicine, 3333 Burnet Ave, Cincinnati, 45229, OH, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, 45229, OH, USA.
| | - Adrienne Borschuk
- Department of Pediatrics, University of Cincinnati, College of Medicine, 3333 Burnet Ave, Cincinnati, 45229, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, 45229, OH, USA.
| | - Catherine Hart
- Department of Otolaryngology, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, 45267, OH, USA.
| | - Kristin Voos
- Department of Pediatrics, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, 44106, OH, USA; Division of Neonatology, University Hospitals Cleveland Medical Center Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, 44106, OH, USA.
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Amherdt S, Kim UO, Basir MA. Effectiveness of Digital Multimedia Educational Aids Produced by Intensive Care Unit Providers. J Pediatr Intensive Care 2018; 7:182-187. [PMID: 31073492 DOI: 10.1055/s-0038-1637747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 02/13/2018] [Indexed: 10/17/2022] Open
Abstract
Multimedia improves understanding of information. Professionally developed digital multimedia educational modules are expensive. We tested educational modules developed by a medical student without extensive multimedia production training. The modules were developed with neonatologist collaboration, uploaded to YouTube, and presented via iPad to neonatal intensive care unit family members who were ≥ 18 years, English literate, and unexposed to topic they were reviewing. Thirty-six participants viewed the modules once and then answered topic-specific key questions. Thirty of 36 (83%) of the participants answered 4/4 (100%) of questions correctly and 6/36 (17%) answered three-fourths (75%) correctly, demonstrating success of the educational modules. Health care workers can economically create effective digital multimedia educational materials without extensive training.
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Affiliation(s)
- Sarah Amherdt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - U Olivia Kim
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Mir A Basir
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Spargo P, de Vries NK. 'Babble': A smartphone app for parents who have a baby in the neonatal unit. J Paediatr Child Health 2018; 54:121-123. [PMID: 29417669 DOI: 10.1111/jpc.13817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/06/2017] [Accepted: 11/15/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Paula Spargo
- Department of Women's Health, MidCentral Health, Palmerston North, New Zealand
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10
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Aydon L, Hauck Y, Murdoch J, Siu D, Sharp M. Transition from hospital to home: Parents' perception of their preparation and readiness for discharge with their preterm infant. J Clin Nurs 2017; 27:269-277. [PMID: 28514524 DOI: 10.1111/jocn.13883] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the experiences of parents with babies born between 28-32 weeks' gestation during transition through the neonatal intensive care unit and discharge to home. BACKGROUND Following birth of a preterm baby, parents undergo a momentous journey through the neonatal intensive care unit prior to their arrival home. The complexity of the journey varies on the degree of prematurity and problems faced by each baby. The neonatal intensive care unit environment has many stressors and facilitating education to assist parents to feel ready for discharge can be challenging for all health professionals. DESIGN Qualitative descriptive design. METHODS The project included two phases, pre- and postdischarge, to capture the experiences of 20 couples (40 parents), whilst their baby was a neonatal intensive care unit inpatient and then after discharge. Face-to-face interviews, an online survey and telephone interviews were employed to gather parent's experiences. Constant comparative analysis was used to identify commonalities between experiences. Recruitment and data collection occurred from October 2014-February 2015. RESULTS/FINDINGS Overlapping themes from both phases revealed three overarching concepts: effective parent staff communication; feeling informed and involved; and being prepared to go home. CONCLUSION Our findings can be used to develop strategies to improve the neonatal intensive care unit stay and discharge experience for parents. Proposed strategies would be to improve information transfer, promote parental contact with the multidisciplinary team, encourage input from fathers to identify their needs and facilitate parental involvement according to individual needs within families. RELEVANCE TO CLINICAL PRACTICE Providing information to parents during their time in hospital, in a consistent and timely manner is an essential component of their preparation when transitioning to home.
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Affiliation(s)
- Laurene Aydon
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia.,Department Nursing and Midwifery Education and Research, Women and Newborn Health Service, Subiaco, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
| | - Yvonne Hauck
- Department Nursing and Midwifery Education and Research, Women and Newborn Health Service, Subiaco, WA, Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Jamee Murdoch
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia.,Department Nursing and Midwifery Education and Research, Women and Newborn Health Service, Subiaco, WA, Australia
| | - Daphne Siu
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia
| | - Mary Sharp
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
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12
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Ronan S, Liberatos P, Weingarten S, Wells P, Garry J, O'Brien K, Parker-Bozzuto S, Schultz SL, Nevid T. Development of Home Educational Materials for Families of Preterm Infants. Neonatal Netw 2016; 34:102-12. [PMID: 26803091 DOI: 10.1891/0730-0832.34.2.102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Parent educational materials describing infant positioning for a home program are vital in supplementing NICU discharge instructions and promoting parent confidence. PURPOSE To document the process of developing a brochure and DVD of a positioning program, using evidence-based practice and NICU expert feedback. METHODS A trifold brochure and companion DVD were developed to demonstrate infant positioning to parents of premature infants for a home developmental program following NICU discharge. A standard process of development was followed for the brochure and DVD script and production. The process included review and comment by eight NICU professionals and several revisions. RESULTS Content of the brochure and DVD and the process entailed in their development is described. Guidelines outlining the process for development of educational materials for families are provided. CONCLUSION Creation of multimedia educational materials for parents of infants who are NICU graduates requires a multistep process to ensure usefulness and validity.
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Abstract
Postpartum discharge instructions are a crucial part of a mother's birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother's satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers' interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class.
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14
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Murray CH, Joseph RA. Transition from NICU to Home: Are the Parents Ready to Manage Any Emergency? An Evidence-Based Project. Neonatal Netw 2016; 35:151-155. [PMID: 27194609 DOI: 10.1891/0730-0832.35.3.151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Transitioning the care of a previously critically ill infant to home poses many challenges for the parents. Prior to the infant's discharge, the parents undergo rigorous training to continue the care of their infants at home. Even after training, parents may feel overwhelmed by the thought of managing an emergency at home. This evidence-based practice project aims to provide parents with additional hands-on practice of cardiopulmonary resuscitation (CPR) prior to their infant's discharge. Based on this project, a program of teaching CPR regularly is established currently in the NICU at Nemours Alfred I. duPont Hospital for Children.
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15
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16
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Rosenstock A, van Manen M. Adolescent parenting in the neonatal intensive care unit. J Adolesc Health 2014; 55:723-9. [PMID: 25287982 DOI: 10.1016/j.jadohealth.2014.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/16/2014] [Accepted: 08/01/2014] [Indexed: 11/26/2022]
Abstract
This review presents data from studies that report on adolescent parents as part of larger neonatal intensive care unit (NICU) parent populations, as well as studies where adolescent parents are given central consideration. A systematic search for English publications from 1990 onward relevant to adolescent parenting in the NICU was conducted. Most studies reporting on adolescent parents focus on parental stress or parenting practices in the NICU. A few studies examine parent-staff communication, parental needs, and parent intervention programs. One study presents a qualitative examination of teenage mothers' experiences in the NICU. Areas for further research include experiences of younger adolescent parents, adolescent fathers, and same-sex partners; issues unique to adolescent parents; and support programs for adolescent parents in the NICU.
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Affiliation(s)
- Amanda Rosenstock
- John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Michael van Manen
- John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada; Neonatal-Perinatal Medicine, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
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Tofil NM, Rutledge C, Zinkan JL, Youngblood AQ, Stone J, Peterson DT, Slayton D, Makris C, Magruder T, White ML. Ventilator caregiver education through the use of high-fidelity pediatric simulators: a pilot study. Clin Pediatr (Phila) 2013; 52:1038-43. [PMID: 24137039 DOI: 10.1177/0009922813505901] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction. Home ventilator programs (HVP) have been developed to train parents of critically ill children. Simulators are used in health care, but not often for parents. We added simulation to our HVP and assessed parents' response. Methods. In July 2008, the HVP at Children's of Alabama added simulation to parent training. Debriefing was provided after the training session to reinforce correct skills and critical thinking. Follow-up surveys were completed after training. Results. Fifteen families participated. All parents were confident in changing tracheostomies, knowing signs of breathing difficulties, and responding to alarms. 71% strongly agree that simulation resulted in feeling better prepared to care for their child. 86% felt simulation improved their confidence in taking care of their child. Conclusion. Simulators provide a crucial transition between learned skills and application. This novel use of simulation-based education improves parents' confidence in emergencies and may lead to shortened training resulting in cost savings.
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Abstract
Mounting evidence shows that low-birth-weight and prematurity are related to serious health problems in adulthood, including increased body fat, decreased fitness, poor bone mineralization, pulmonary problems, and cardiovascular disease. There are data to suggest that increasing physical activity in preterm infants will have effects on short-term muscle mass and fat mass, but we also hypothesized that increasing physical activity early in life can lead to improved health outcomes in adulthood. Because few studies have addressed the augmentation of physical activity in premature babies, the objective of this study was to evaluate the feasibility of whether caregivers (mostly mothers) can learn from nurses and other healthcare providers to implement a program of assisted infant exercise following discharge. Ten caregivers of preterm infants were taught by nurses, along with occupational therapists and other healthcare providers, to perform assisted infant exercise and instructed to conduct the exercises daily for approximately 3 weeks. The researchers made home visits and conducted qualitative interviews to understand the caregivers' experiences with this exercise protocol. Quantitative data included a caregiver's daily log of the exercises completed to measure adherence as well as videotaped caregiver sessions, which were used to record errors as a measure of proficiency in the exercise technique. On average, the caregivers completed a daily log on 92% of the days enrolled in the study and reported performing the exercises on 93% of the days recorded. Caregivers made an average of 1.8 errors on 2 tests (with a maximum of 23 or 35 items on each, respectively) when demonstrating proficiency in the exercise techniques. All caregivers described the exercises as beneficial for their infants, and many reported that these interventions fostered increased bonding with their babies. Nearly all reported feeling "scared" of hurting their babies during the first few days of home exercise but stated that fears were alleviated by practice in the home and further teaching and learning. Caregivers were willing and able to do the exercises correctly, and they expressed a belief that the intervention had positive effects on their babies and on caregiver-infant interactions. These findings have important implications for nursing practice because nurses are in key positions to teach and encourage caregivers to practice these exercises with their newborn babies.
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Boykova M, Kenner C. International Connections: Transition From Hospital to Home: Post–Neonatal Intensive Care Unit Discharge: A Global Perspective. ACTA ACUST UNITED AC 2012. [DOI: 10.1053/j.nainr.2012.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Haller K, Waggoner M. Depicting car seat safety. Nurs Womens Health 2012; 16:107-108. [PMID: 22900766 DOI: 10.1111/j.1751-486x.2012.01714.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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