Nurses' role in promoting relations between parents and premature newborns in accordance with the concept of Family-Centered Care

The Role of the NICU in Father Involvement, Beliefs, and Confidence: A Follow-up Qualitative Study

BACKGROUND

Fathers are important to infant outcomes. Infants of involved fathers have improved weight gain, sleep, and psychosocial behaviors. Father involvement with neonatal intensive care unit (NICU) infants reduces the length of stay.

PURPOSE

The purpose of this study was to explore and describe involvement, confidence, and beliefs of fathers of infants who were hospitalized in the NICU and discharged home in order to begin to investigate NICU father involvement from a longitudinal perspective.

METHODS

This exploratory qualitative study was conducted 4 to 5 years after the initial NICU stay using telephone interviews. Fathers who participated in this study were selected from participants of a previous NICU study. Qualitative analysis was conducted using standard procedures for grounded theory.

RESULTS

Nineteen fathers participated in the study. The major themes were "It was scary," "Just be there," "It was rough," "It's not about yourself," "A special bond," and "Almost a treat." The fathers reported that the NICU providers, nurses, and staff helped them to overcome uncertainty and lack of knowledge, which helped them improve their confidence and involvement during the NICU stay.

IMPLICATIONS FOR PRACTICE

Fathers see nurses as a source of support. Nurses can encourage fathers to visit regularly and participate in infant care activities. NICU presence aids fathers in developing confidence and knowledge in parenting during their child's infancy, which can set the stage for ongoing involvement.

IMPLICATIONS FOR RESEARCH

Future work should continue to focus on longitudinal studies of fathering and the role of the NICU in encouraging involvement and parenting readiness.

Factors Affecting Time NICU Nurses Spend With Fathers: Results From a Larger Study

BACKGROUND

Father involvement in the neonatal intensive care unit (NICU) is important for outcomes of children and should be encouraged. Neonatal nurses have been identified as a major source of support for fathers; yet, nurses have identified obstacles to family-centered care of the father.

PURPOSE

The purpose of this article is to present results that broaden the knowledge of factors that affect time NICU nurses spend with fathers. The information presented here is a portion of results from a larger survey that examined factors affecting NICU nurse caring beliefs of fathers.

METHODS

This survey study included NICU nurses and was administered anonymously online. Content analysis was completed on responses to open-ended questions.

RESULTS

Questions asked nurses about the time they spend with fathers. Nurses described problems with workflow and encouraged family bonding. Some nurses described spending equal amounts of time with both parents, whereas others focused on either the mother or the father. Paternal attributes that affected time nurses spent with fathers included confidence, motivation, level of competence, beliefs, attitudes, and availability. Maternal factors included culture and gatekeeping. Infant factors were level of illness and tolerance to activity.

IMPLICATIONS FOR PRACTICE

Unmotivated fathers may benefit from encouragement from nurses to participate in the care of their infants. Nurses can encourage parental partnerships in caring for their infants.

IMPLICATIONS FOR RESEARCH

Factors identified in this study can help guide future studies. Understanding the relationship between NICU fathers and nurses can help improve interactions and communication.

Interdisciplinary Family Conferences to Improve Patient Experience in the Neonatal Intensive Care Unit

Parents play a significant role in the development of their neonate. They can affect the length of stay in a neonatal intensive care unit (NICU) and are seen as an integral part of the team. Parents are often put in positions where difficult decision making is required of them in the care of their critically ill child. Studies suggest that one way to improve the family's experience and to encourage their involvement is by establishing a formal and focused family conference. Therefore, the NICU social workers and the interdisciplinary team collaborated to formulate strategies to improve communication that would enhance current practice. As a new initiative, the team decided that holding an interdisciplinary family conference (IFC) within the first two weeks of a baby's NICU admission is critical for parental involvement of infants less than 32 weeks gestation and those with congenital birth anomalies. The team determined that the primary outcome measure would be family satisfaction scores from hospital surveys. Since the implementation of IFCs, satisfaction scores showed steady improvement. This quality improvement project demonstrated that IFCs are an integral part of the family-centered care approach in the NICU. IFCs foster partnerships with families to ensure their involvement in all aspects of patient care and improve their experience in the NICU.