Factors influencing implementation of Family-Centered Care in a Neonatal Intensive Care Unit, a qualitative approach.

Abstract

Background: Approximately 9,6% of all births worldwide are preterm. These infants are often admitted at a Neonatal Intensive Care Unit (NICU). The NICU environment is very stressful for preterm infants and separation of the parents causes stress for both infant and parent. Family-Centered Care (FCC) is an approach of planning, delivery, and evaluation of healthcare and based on a partnership between healthcare professionals and families of patients. Parents of infants who were admitted to an FCC unit were less stressed compared to parents at a Standard Care unit. Although FCC is beneficial to families and patients, implementation can be challenging. Therefore it is important that factors influencing the implementation of FFC are known. Aim: To explore factors that influence implementation of Familiy-Centered Care in a Neonatal Intensive Care Unit according to healthcare professionals that already work with Family-Centered Care in three different countries Method: A descriptive generic qualitative design with semi-structured interviews and thematic analyses was used. This multi-center study was conducted in three hospitals in three countries: Sweden, Norway and The Netherlands. Results: The sample consists of seven neonatal care nurses, one nurse assistant, five neonatologists and three managers. Four themes were identified: Behavioural change in staff, Family needs, Environment and Communication. Healthcare professionals described that the mindset of the professional influences the implementation of FCC. Conclusion: The mindset of healthcare professionals in seeing parents as primary caregiver is important. This influences the way FCC is practiced and how parents are involved in the care for their infant. Implications of key findings: In FCC the role of healthcare professional changes, it is important to prepare the staff for this change by involving the staff early in the implementation process of FCC.