Effects of the Close Collaboration With Parents Intervention on the Quality of Family-Centered Care in NICUs.

BACKGROUND: Systematic training for the neonatal staff to support parents' active involvement is lacking. There is little information about the effectiveness of educational interventions. PURPOSE: To evaluate the effects of an educational intervention to neonatal staff on the quality of family-centered care from the perspectives of parents and nurses. METHODS: A quasi-experimental before and after study was carried out in 5 Finnish neonatal units in 2014-2018. Data were collected using the DigiFCC-tools with a 7-point Likert scale. Thirty-one fathers and 53 mothers were recruited before the intervention and 21 fathers and 61 mothers after the intervention. They answered 1 question every evening until their infants' discharge. Each nurse answered 1 corresponding question after every shift, during the same period before and after the intervention. Before the intervention 3239 responses and after the intervention 3092 responses were received from nurses. RESULTS: The fathers' total score and the score indicating "Shared decision making" were higher after the intervention than before the intervention. The mothers' total score did not differ between the 2 time periods. The nurses' total score was higher after the intervention than before the intervention. Of the individual items, higher scores were found for "Active listening," "Parents' trust in the nurse," and "Emotional support." IMPLICATIONS FOR PRACTICE: Developing the staff's negotiating and active listening skills facilitates better support for parents during infants' intensive care. IMPLICATIONS FOR RESEARCH: Family-centered care interventions such as Close Collaboration with Parents should be studied in randomized controlled trials, also including child outcomes.

Close Collaboration with Parents intervention improves family-centered care in different neonatal unit contexts: a pre-post study.

BACKGROUND: The quality of family-centered care and parental participation in care in neonatal units differ widely across the world. Appropriate education might be an effective way to support medical staff in neonatal units to collaborate with parents and implement family-centered care. The aim of this study was to evaluate the effects of the educational intervention on the quality of family-centered care in eight Finnish neonatal intensive care units from both the staff and parent perspectives. METHODS: A mixed-method pre-post intervention study was conducted in eight neonatal intensive care units in Finland. Data were collected from staff and parents using the Bliss Baby Charter audit tool and semi-structured interviews. RESULTS: The quality of family-centered care, as assessed by staff and parents, increased significantly after the intervention in all eight units. The intervention was able to help staff define and apply elements of family-centered care, such as shared decision making and collaboration between parents and staff. In interviews, staff described that they learned to support and trust the parents' ability to take care of their infant. CONCLUSIONS: The educational intervention increased the quality of family-centered care and enabled mutual partnership between parents and staff. IMPACT: This study shows that the educational intervention for the whole multi-professional staff of the neonatal unit improved the quality of family-centered care. The Close Collaboration with Parents intervention enabled mutual partnership between parents and staff. It also provides evidence that during The Close Collaboration with Parents intervention staff learned to trust the parents' ability to take care of their infant.

Key factors supporting implementation of a training program for neonatal family- centered care - a qualitative study.

BACKGROUND: Traditionally, the care of infants in neonatal care units has been professionally centered, paying less attention to family support. In recent years, many interventions have been developed to improve family-centered care and thereby parent and infant outcomes. Understanding the key factors of implementation of these interventions would help improve clinical practice. The aim of this study was to describe the staff's perceptions of the implementation of the Close Collaboration with Parents Training Program and to identify the barriers and facilitators of the implementation. METHODS: A descriptive qualitative interview study was conducted in eight neonatal intensive care units in Finland. Nineteen unit managers and 32 nurses were interviewed after their unit had finished the 1.5-year training program. Data were analyzed using thematic content analysis. RESULTS: Key factors facilitating the implementation of the training program were multidisciplinary commitment and the staff's motivation to change their professional role to work as the parents' facilitator. Observable benefits promoted the implementation, as well as experiential learning as a facilitation method. The role of mentor was remarkable as a facilitator. In addition, contextual elements such as support from leadership and proper timing were important. CONCLUSIONS: Implementation of family-centered care is facilitated by staff who is prepared to accept parents as partners and adopt a new professional role. Enough time for preparation, readiness for the change, solid support from the leadership, and a multidisciplinary approach are needed as well. Mentoring was found to be one of the key factors facilitating the change.

Effects of single-family rooms on nurse-parent and nurse-infant interaction in neonatal intensive care unit.

BACKGROUND: Single-family rooms in neonatal intensive care unit can provide longer interaction between family and staff. On the other hand, separation in private rooms has been shown detrimental to child development if parents are not present. AIMS: To examine the effects of single-family rooms on nurse-family, nurse-parent and nurse-infant interaction time in neonatal intensive care unit. STUDY DESIGN: A quantitative, comparative, observational study was conducted before and after a move to a neonatal intensive care unit with single-family rooms. A total of 194 observation hours were conducted before the move and 194h after the move. The differences were analyzed using a hierarchical linear mixed model. SUBJECTS: Nurses working in one neonatal intensive care unit were recruited to study. OUTCOME MEASURES: The duration and number of nurse-parent and nurse-infant interaction episodes were recorded. RESULTS: The nurse-family and the nurse-parent interaction were longer in the unit with single-family rooms compared with the unit before the move (mean 261 vs. 138min per shift, p<0.0001 and 117 vs. 35, p=0.001, respectively). The duration of the nurse-infant interaction did not change after the move. The frequency of the nurse-parent or the nurse-infant interactions did not change between the time periods. CONCLUSIONS: Neonatal intensive care unit with single-family rooms supported an increase in nurse-parent interaction time. Importantly, nurse-infant interaction time did not decrease.