Registed Nurses' Association of Ontario

Promoting Family-Centered Care In the NICU

MaryAnn Ottenhof
Kington General Hospital

This RNAO Fellowship has advanced my leadership skills tremendously. It started out as a desire to gain knowledge about Family Centered Care, and has grown into something much more. Through this fellowship I have been able to establish a research study “Family Integrated Care “into the NICU at Kingston General Hospital. It is predicted that Family Integrated Care (FiCare) will soon be the model of care in all NICU’s. This care model incorporates parents into the NICU care team as an integral part of the team. The parents provide most of the basic baby care for their stable infants with the exception of intravenous procedures and medications, whereas the nurse becomes the educator, coach and mentor. This represents a significant shift from existing Family Centered Care Models. Family Integrated Care (FICare) is a program designed by a multidisciplinary steering committee at Mount Sinai Hospital that included parents of prior NICU patients, nurses, doctors, a parent educator, a lactation consultant and a social worker. It is modeled after “Humane Neonatal Care” in Tallinn, Estonia where parents were expected to provide all the care for their infants. What was discovered was that this type of psychological care has short and long term benefits for both the infant and their parents.

The definition of Family Centered Care (FCC) is “The professional support of the child and family through a process of involvement, participation and partnership underpinned by empowerment and negotiation.” (1). Family Centered care is a way of caring for infants and families which ensures that care is planned around the whole family, not just the individual infant or child and in which all the family members are recognized as care recipients.

The implications for families of premature and sick infants include physical and emotional separation and alienation from their baby. This subsequently strains the early parent-infant bonding process and can put parents under enormous stress. Family Centered Care is seen as placing the needs of the individual infant in the context of the family. FCC is an approach to medical care rooted in the belief that optimal health outcomes are achieved when patient’s family members play an active role in the providing emotional, social and developmental support. Family members, especially parents are natural advocates for the neonatal patient for whom emotional, social and developmental needs are serious and urgent. A Family Centered Care approach also benefits parents as it allows them to become informed and more involved in the care of their infant and as a result they become more confident and competent in there parenting abilities. The benefits of FCC include improved satisfaction with the care provided in the NICU, decreased parental stress, increased parental comfort and competence with post-discharge care, improved success with breastfeeding, shortened length of stay, decreased readmissions and increased staff satisfaction.

I believe that the Family Integrated Care Program is family centered care, specific to the NICU. The two go hand in hand to provide the best possible care for our most vulnerable infants and their families. It is the goal of the whole interprofessional team of the NICU to send home a healthy baby to confident and competent parents.

Thank you to everyone, especially my mentoring team and the administrative staff who helped make this project successful. I couldn’t have done it without you.

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