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PEDIATRICS Vol. 111 No. 4 April 2003, pp. e437-e449

ELECTRONIC ARTICLE

Evaluation and Development of Potentially Better Practices for Improving Family-Centered Care in Neonatal Intensive Care Units

Roger P. Saunders, RN, MSN, PNP*, Marie R. Abraham, MA{ddagger}, Mary Jo Crosby, RNC, NNP, MS§, Karen Thomas, APRN, BC|| and William H. Edwards, MD

* Women’s Hospital of Greensboro, Greensboro, North Carolina
{ddagger} Institute for Family-Centered Care, Bethesda, Maryland
§ Children’s Hospitals and Clinics, Minneapolis, Minnesota
|| DeVos Children’s Hospital, Grand Rapids, Michigan
Children’s Hospital at Dartmouth, Lebanon, New Hampshire

--> Objective. Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant’s physical needs. Parents’ participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care.

Methods. Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted.

Results. Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000).

Conclusions. Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.

Key Words: family-centered care • parental involvement • collaborative quality improvement • multidisciplinary • benchmarking • neonatal intensive care • NIC/Q 2000

Abbreviations: NICU, neonatal intensive care unit • NIC/Q 2000, Neonatal Intensive Care Unit Quality Improvement Collaborative Year 2000 • VLBW, very low birth weight • PBP, potentially better practice • IFCC, Institute for Family-Centered Care • PO, oral

Received for publication Aug 13, 2002; Accepted Oct 24, 2002.


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