Parents Matter: Examination of Family Presence in the Neonatal Intensive Care Unit

Saxton, Sage N.; Walker, Bethany L.; Dukhovny, Dmitry

doi:10.1055/s-0040-1701506

Cited by 14 publications

(28 citation statements)

References 48 publications

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“…Although parent engagement within the NICU setting has been identified as a factor that can improve outcomes [13,14], suboptimal parent presence and holding remain prevalent in the United States [15][16][17][18]. A longer period of exposure to the NICU environment could be assumed to have a greater impact on neurodevelopmental outcome as positive sensory exposures may be lacking, nurturing touch by a parent may not be optimal, and negative sensory exposures dominate.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Neurodevelopmental Outcomes following Preterm Birth and the Association with Postmenstrual Age at Discharge

et al. 2022

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Objective: To 1) define the prevalence of motor, cognitive, and language delays in preterm infants born < 32 weeks estimated gestational age (EGA) and 2) identify the relationship between the timing of discharge from the NICU and neurodevelopmental outcome in early childhood. Study Design: This retrospective study of 176 preterm infants born < 32 weeks EGA and hospitalized in a level IV NICU captured medical factors, including timing of discharge, from the NICU stay. Standardized developmental testing at 1-2 years corrected age was conducted in the newborn follow-up clinic. Results: At 1-2 years corrected age, the sample had an average cognitive composite score of 91.5 ± 17.4, language composite score of 84.5 ± 17.3, and motor composite score of 88.9 ± 18.4. Lower EGA at birth, necrotizing enterocolitis, patent ductus arteriosus, and oxygen requirement for > 28 days were independently associated with higher postmenstrual age (PMA) at NICU discharge. After controlling for known risk factors, higher PMA at discharge was associated with poorer cognitive outcome [p < 0.001, (-0.16, -0.07), β = -0.35], poorer language outcome [p = 0.049 (-0.10, 0.00), β = -0.15] and poorer motor outcome [p < 0.001, (-0.14, -0.05), β = -0.30]. Conclusion: Poorer cognitive, language, and motor outcomes were associated with longer hospitalization, even after controlling for medical risk factors known to be associated with poorer outcome. This provides further evidence for the potential role of the environment that may be impacting the developmental outcomes of infants hospitalized in the NICU.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Neurodevelopmental Outcomes following Preterm Birth and the Association with Postmenstrual Age at Discharge

et al. 2022

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“…Nonetheless, parents are often left out of important decision-making and care for their preterm infant. This can be puzzling for researchers and policy makers when there is evidence that parental presence and integration into their infant's care have a positive influence on patient and family outcomes 4,12…”

Section: Background and Significancementioning

confidence: 99%

“…policy makers when there is evidence that parental presence and integration into their infant's care have a positive influence on patient and family outcomes. 4,12 The literature is replete with research substantiating the benefits of parental presence, collaborative communication, and improved outcomes for parents and infants who experience FICare. 1,11 However, there is limited empirical description of the workful actions that parents do to be present.…”

mentioning

confidence: 99%

The Work of Mothering in the NICU

Ringham¹,

McNeil²,

Benzies³

2022

Advances in Neonatal Care

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Background: Integrating parents into the care of their infants in the neonatal intensive care unit (NICU) is vital for both parents and infants. Yet, parents are often not fully involved in important decision-making and care, even when practices are family- and patient-centered. Alberta Family Integrated Care (FICare) is a model of care designed to support integration of parents into their infant's care. Purpose: The aim of this study was to describe and examine how mothers' work was coordinated by institutional processes when participating in Alberta FICare. Methods: We used institutional ethnography to analyze written entries in Alberta FICare parent journals to show points of tension mothers experienced in the NICU. Results: We illustrated the institutional activities that intersect with parental work of being present in the NICU. We argue that the journal text and the primary discourses that mothers are tuned to organize the way they knew and thought about their infant. Managing everyday NICU rules, navigating constant and unexpected changes, and the work of feeding their infant created tension. Mothers focused on milk supply, weight gain, and transition from gavage to nipple feeds. We show how mothers' activities were coordinated by practices that prioritize progression toward discharge rather than supporting them through the roller coaster of emotions and practical challenges of being present in the NICU. Implications for Practice: This illustration of institutional systems and processes may assist practitioners to understand the barriers mothers face when caring for their infants in the NICU.

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“…1 Admission to the NICU is often an unexpected occurrence that interferes with normal parental roles and parent-infant bonding. 2 In the 1970s, shortly after NICUs became widespread, parental presence became a concern when it was noticed that infants admitted to the NICU may be at increased risk for neglect, abandonment, and abuse from infrequently present parents. 3,4 Additional unintended negative effects of NICU hospitalization may include delayed early childhood development, 5 maternal psychological distress, and altered parental behavior both during and after the NICU period.…”

mentioning

confidence: 99%

“…[6][7][8][9] It is widely believed that increased parental presence and involvement in infant caregiving in the NICU may mitigate negative outcomes of NICU care for both infants and parents. 2 When parental visiting restrictions are lifted, infants have a shorter length of stay. 10 Infants whose parents are more present and participating in infant care also show improvement in early neurobehavioral outcomes.…”

mentioning

confidence: 99%

Measuring Parental Presence in the Neonatal Intensive Care Unit

et al. 2020

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Parental presence is believed to improve outcomes for infants hospitalized in the neonatal intensive care unit (NICU). As a result, NICU policies and procedures have evolved to support parental presence, and a growing number of studies examine the role of parental presence in the NICU. However, the measurement of parental presence is not standardized, complicating assessment of its impact on child and parent outcomes across studies. We reviewed 29 studies that presented 27 distinct methods of quantifying parental presence in the NICU and reported associations of presence with patient demographics, parental engagement in the NICU, and outcomes for both infants and parents. This overview provides a foundation for standardizing and improving routine measurement of parental presence in the NICU. Key Points

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Parents Matter: Examination of Family Presence in the Neonatal Intensive Care Unit

Abstract: Key Points

Cited by 14 publications

References 48 publications

Neurodevelopmental Outcomes following Preterm Birth and the Association with Postmenstrual Age at Discharge

Neurodevelopmental Outcomes following Preterm Birth and the Association with Postmenstrual Age at Discharge

The Work of Mothering in the NICU

Measuring Parental Presence in the Neonatal Intensive Care Unit

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