Implementing Evidence-Informed Discharge Preparedness Tools in the NICU

Abstract

Background: Few studies address preparing parents of neonatal intensive care unit (NICU) infants for infant discharge. Inadequate or ineffective parental preparedness for discharge can result in preventable emergency department and primary care visits. Parents' perceptions are needed to inform development and implementation of effective educational tools to improve parent discharge preparedness in the NICU. Purpose: To describe the perceptions of parents of recently discharged NICU infants regarding discharge preparedness and implementation of the My Flight Plan for Home parent discharge preparedness tool. Methods: We used a qualitative descriptive design to collect individual interview data from 15 parents with infants discharged from a level 4 NICU in the Midwest. Individual interviews were conducted using a semistructured guide and were audio-recorded, transcribed verbatim, and thematically analyzed using the constant comparative method. Results: We identified 5 major themes: (1) family dynamics; (2) parenting in the NICU; (3) discharge preparedness; (4) engaging parents in infant care; and (5) implementation recommendations for the My Flight Plan for Home tool. Minor themes supported each of the major themes. Implications for Practice: To improve parents' confidence in caring for their infant after discharge, parents suggest nurses must engage parents in discharge education and infant care shortly following NICU admission and use parentcentered discharge preparedness tools. Implications for Research: Future studies are needed to develop and test parent-tailored strategies for implementing parent discharge preparedness tools in the NICU.

Family‐centred care and breastfeeding self‐efficacy determined how ready mothers were for their infants to be discharged from a neonatal intensive care unit

“…The same study also reported that parents with other children at home felt better prepared for their infant to be discharged from the NICU than first-time parents. 12 The point about siblings was in line with the findings of quantitative studies that were conducted with the parents of hospitalised children 6 and with mothers during the postpartum period. 14 The stress that parents experience when their infants are hospitalised has been well established.…”

“…12,13 A qualitative study found that when infants stayed in NICUs for more than 50 days, their parents felt better prepared for them to be discharged than the parents of infants with a shorter NICU stay. 12 It may be that extended stays provide more time for healthcare staff to teach parents about their infant's specific care needs. The same study also reported that parents with other children at home felt better prepared for their infant to be discharged from the NICU than first-time parents.…”

“…5,[9][10][11] Although there is little evidence from quantitative studies about how ready parents are to have their infants discharged from NICUs, qualitative studies have highlighted factors that warrant investigation. 12,13 A qualitative study found that when infants stayed in NICUs for more than 50 days, their parents felt better prepared for them to be discharged than the parents of infants with a shorter NICU stay. 12 It may be that extended stays provide more time for healthcare staff to teach parents about their infant's specific care needs.…”

Factors Influencing Parents' Perception of Their Infants' Transition From a 6-Bed Pod to Single Family Room in a Mixed-Room Neonatal Intensive Care Unit

“…Although the impact of having a previous NICU admission has not been explored to our knowledge in NICU transition literature, some studies have examined how parity impacts readiness for discharge and discharge-teaching needs. For example, a study by Mazur et al23 found that parents with other children at home were more prepared to care for their infant independently but may have less time to spend at the hospital. The study also reported how fathers, in particular, may be less present in the NICU if they have other children at home due to caregiving needs of those children 23.…”

“…For example, a study by Mazur et al23 found that parents with other children at home were more prepared to care for their infant independently but may have less time to spend at the hospital. The study also reported how fathers, in particular, may be less present in the NICU if they have other children at home due to caregiving needs of those children 23. Although both mothers and fathers in this study found having other children to be facilitating, these results point to the need for tailored information regarding this transition.…”