The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study

Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.

Download Full-text

Nurses’ Perspective Prior to Family Integrated Care (FICare ) Implementation in Neonatal Intensive Care Unit at Kemh and Pmh

Journal of Paediatrics and Child Health ◽

10.1111/jpc.13882_169 ◽

2018 ◽

Vol 54 ◽

pp. 65-66

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Integrated Care ◽

Neonatal Intensive Care ◽

Family Integrated Care ◽

Family Integrated

Download Full-text

Legal complaints about midwives and the impact on the profession

Nursing Ethics ◽

10.1177/0969733016689816 ◽

2017 ◽

Vol 26 (1) ◽

pp. 148-160 ◽

Cited By ~ 4

Author(s):

Akram Peyman ◽

Nahid Dehghan Nayeri ◽

Mohammad Esmaeilpour Bandboni ◽

Zahra Behboodi Moghadam

Keyword(s):

Qualitative Content Analysis ◽

Well Being ◽

Professional Status ◽

Medical Sciences ◽

Structured Interviews ◽

Ethical Considerations ◽

Written Text ◽

Litigation Process ◽

Training Professional ◽

The Impact

Introduction: Midwives play an important role in maintaining and increasing women’s health and well-being. Training professional midwives is one of the main policies of any healthcare system. Since the number of complaints against midwives has increased recently, this study was conducted to explore the perspectives of midwives regarding patients’ complaint to authorities and their impacts on the profession of midwifery. Methods: Being conducted in 2013, this qualitative study was the first of its type in Iran. Data were collected through in-depth semi-structured interviews with 14 midwives working in different cities across the country. The participants were selected using a purposive sampling method. Interviews were transcribed verbatim and analyzed following a qualitative content analysis approach. Written text was then coded, and themes were extracted from the data. Ethical considerations: The study was conducted with midwives’ free informed consent and was approved by Ethics Committee of Tehran University of Medical Sciences. Findings: By analyzing the data, four main themes regarding the impact of complaint on midwifery profession were developed. These included the following: “dissatisfied of midwifery, professional deviation, obsession with work, and weakening of the professional status.” Conclusion: The experience of patients’ complaint to legal authorities against midwives was described, by participants, as a painful experience. Lack of midwives’ knowledge about professional rules and litigation process created many problems for them and could negatively affect their practice and the society’s attitude toward midwifery. Thus, we suggest that in order to prevent such problems, midwives and midwifery students should be educated regarding factors that have the potential to create such problems and also prevention strategies.

Download Full-text

Scaling Up the Family Integrated Care Model in a Level IIIC Neonatal Intensive Care Unit: A Systematic Approach to the Methods and Effort Taken for Implementation

Frontiers in Pediatrics ◽

10.3389/fped.2021.682097 ◽

2021 ◽

Vol 9 ◽

Author(s):

Bárbara Moreno-Sanz ◽

María Teresa Montes ◽

Marta Antón ◽

María Teresa Serrada ◽

Marta Cabrera ◽

...

Keyword(s):

Intensive Care ◽

Integrated Care ◽

Neonatal Intensive Care ◽

Scale Up ◽

Healthcare Personnel ◽

Care Needs ◽

Dissemination Strategy ◽

Essential Components ◽

Family Integrated Care ◽

Family Integrated

Background: Family Integrated Care (FICare) integrates parents in the direct care of their child while the healthcare personnel act as teachers and guides. To this date, most reports on the feasibility of this model refer to stable preterm infants admitted to Neonatal Intensive Care Units (NICUs).Objectives: To scale up and adapt FICare to make it suitable in level IIIC NICUs, which care for extreme prematurity and other complex medical or surgical neonatal conditions.Materials and Methods: Step 1 was the creation of the FICare implementation team (FICare-IT) and baseline analysis of current procedures for critical care to identify needs, wishes, and requirements; we aimed for protocol elaboration tailored to our cultural, architectural, and clinical context (March 2017 to April 2018). Step 2 as a dissemination strategy by FICare-IT acting as primary trainers and mentors to ensure the education of 90% of nursing staff (May 2018 to July 2018). Step 3 involved piloting and evaluation with the aim to refine the procedure (July 2018 to December 2020).Results: A rigorous but flexible protocol was edited. The FICare educational manual included two curricula: for healthcare professionals/staff (Training the trainers) and for families (Education of caregivers), the latter being categorized in two intervention levels (basic and advanced), depending on the infant care needs and parent's decision. In total, 76 families and 91 infants (74.7% preterm; 18.7% complex surgery; 6.6% others) were enrolled in the pilot. No differences in acceptance rate (overall 86.4%) or in the number of infant-family dyads in the program per month were observed when considering the pre- and post-Covid-19 pandemic periods. All families, except for one who dropped out of the program, completed the agreed individualized training. Mothers spent more time in NICU than fathers (p < 0.05); uninterrupted time spent by mothers in NICU was longer during the pre-pandemic period (p < 0.01). Observed time to reach proficiency by task was within the expected time in 70% of the program contents. The parents revealed educational manuals, workshops, and cot-side teaching sessions as essential for their training, and 100% said they would accept entry into the FICare program again.Conclusions: The principles of the FICare model are suitable for all levels of care in NICUs. Leadership and continuous evaluation/refinement of implementation procedures are essential components to achieve the objectives.

Download Full-text

The Perceptions and Experiences of Parents and Families of Preterm Infants Who Participate in Family Integrated Care Programs in Neonatal Intensive Care Units: A Qualitative Systematic Review Protocol

10.21203/rs.3.rs-509989/v1 ◽

2021 ◽

Author(s):

Rebecca Anne Carman ◽

Claire Adams ◽

Mary Sharp ◽

Daniel McAullay ◽

Rhonda Marriott ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Integrated Care ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Care Program ◽

The Family ◽

Full Text Review ◽

Family Integrated Care ◽

Family Integrated

Abstract BackgroundThe premature birth of an infant coupled with admission to a Neonatal Intensive Care Unit (NICU) can pose complex psychosocial challenges to parents and the family unit. Measures designed to counteract the effects of restricted visitation and prolonged separation from the infant within the NICU setting have led to the development of the Family Integrated Care model; emphasis in this program is placed on the active participation of the parent alongside the healthcare team in providing direct care to the preterm infant. The aim of this systematic review is to explore the perceptions and experiences of parents and families of preterm infants who have used a Family Integrated Care program during hospitalisation in a NICU. MethodsA systematic literature search will be performed on six electronic databases (Medline, CINAHL, Embase, PsycINFO, Web of Science, and Scopus) to identify relevant articles which meet the a priori inclusion criteria. A hand-search of the reference lists of all articles taken to full text review will supplement the search. The search will be limited to peer-reviewed, primary research articles written in English only; nil publication date restrictions will be applied. Two independent reviewers will screen all retrieved articles, perform the full-text review, critically appraise the included articles, and extract the data. Where consensus cannot be reached, a third reviewer will be consulted. To assess the quality of included studies and the risk of bias, the Critical Appraisal Skills Programme checklist will be used. Data will be extracted using a data extraction tool developed by the review team and piloted for use by two independent reviewers. A thematic analysis and narrative synthesis of the review findings will follow. DiscussionThis review will importantly describe the experiences of parents and families of preterm infants using a Family Integrated Care program delivered within a NICU; review findings will be used to inform the associated program protocols in a Perth (Western Australia) based NICU and be disseminated via a peer-reviewed publication. Systematic review registration: PROSPERO, Submission ID: 243818.

Download Full-text