Next Newborn / Neonatal

Initiative

General Meeting
March 7, 2017
 Initiative

Improving
Family Centered Care
in the NICU
 What is FCC?

Family Centered Care is NOT

something you do for a family or to a
family, it is a culture.
Institute for Patient and Family
Centered Care toolkit for
improvement of FCC.

http://www.ipfcc.org/bestpractices/better-
together-toc.html
 Initiative Background

Patient- and Family-Centered Care in

the NICU
Listening to and respecting each child and his or
her family
Ensuring flexibility in organizational polices procedures
and practices
Sharing complete, honest and unbiased information
with patients
Providing and/or ensuring formal and informal
support
Collaborating with patients and families at all levels of
health care
Recognizing and building on the strengths of individual
children and families
AAP, 2012; Johnson,
2009
 Initiative Aim

Decrease delays in
getting family involved
during newborns stay
 Initiative Background

Current state of care:

Unknown

Core Measures of developmental care in

the NICU:
Family is defined by parents
Unrestricted access by family
Family well-being documentation
Short and long term family assistance
Verklan,
2015
 Initiative Impact

Promotion of the Family Centered Experience:

Increases quality of care

Increases safety of care
Increases early breastfeeding
rates

Clottey 2013; Lee, 2014

Initiative Reach
 Kangaroo Care Benefits

Does not increase mortality or morbidity

Increases rates of breastfeeding
Reduces maternal stress
Reduces incidence of postpartum
depression
Improves cardiorespiratory
stability
Improves sleepwake cycles
Improves thermoregulation
Promotes parentinfant
bonding
Experts from the 7th International Workshop on KMC
concluded that considering the stability of the mother
and infant, KC should be the preferred method and
standard of care. Whitelaw, 1988; Nyqvist,
2010
 Kangaroo Care Barriers

Inconsistency in Top Nursing

Eligibility Concerns
Differences in practice led to
Temperature
feelings of dissatisfaction and control
confusion for parents
Airway
Comfortable Equipment management
Availability
Neonatal
Not all nursing staff understood stress
the positive impact on both
Neonatal Size
mothers and infants
Stikes, 2013 Staff Time
 Initiative extensions

Next steps?

Electronic communication for acutely ill

mothers
Decreased time to start pumping
Antepartum education
In closing
In closing
 Supporting Materials

AAP. (2012) Patient- and family-centered care and the

pediatricians role. doi::10.1542/peds.2011-3084
Binder, W., Zeltzer, L., Simmons, C., Mirocha, J., & Pandya,
A. (2011). The father in the hallway: Posttraumatic
stress reactions in fathers of NICU babies. Psychiatric Annals,
(41)8, 396-402.
Clottey, M., & Dillard, D. (2013). Post-traumatic stress
disorder and neonatal intensive care. International
Journal of Childbirth Education, (28)3, 23-30.
Frampton, S., & Guastello, S. (2010) Putting patients first:
Patient-centered care: More than the sum of its parts. American
Journal of Nursing, 110(9), 49-53.
Hodges, P. (2017) What is NICU family-centered care? Preemie babies
101. Retrieved from http://www.preemiebabies101.com/nicu-
family-centered-care/
 Supporting Materials

Institute for family-centered care. Advancing the practice of

patient-and
family centered care. How to Get Started, Bethedsa MD,
2008.
Institute of medicine. Best care at lower cost: the path to
continuously
learning health care in America. Washington DC, National
Acadmies
Press, 2012.
Jeffries, A. (2012) Kangaroo care for the preterm infant and
family. Pdiatric
child health 17(3), 141-143
Johnson, B., Abraham, N., & Shelton, T. (2009) Patient- and
family- centered care: Partnerships for quality and safety.
North Carolina Medical Journal, 70(2), 125-130.
Lee, L., Carter, M., Stevenson, S., & Harrison, H. (2014)
 Supporting Materials

Nyqvist, K., Anderson, G., Bergman, N., Cattaneo, A., Charpak,

N., Davanzo,
R., & Widstrom, A. (2010). Towards universal kangaroo
mother
care: Recommendations and report from the first European
conference and seventh International workshop on
kangaroo mother
care. Acta Pdiatrica, Nurturing the Child.
doi: 10.1111/j.1651-2227.2010.01787.x
Verklan, M., Walden, M. (2015). Developmental Support by
Spruill, C., in Core
Curriculum for neonatal intensive care nursing 5th edition
AWHONN,
AADDN, NANN, Elsevier Saunders, St. Louis, MO.