NICU Nurses and Families Partnering to Provide Family-Centered Developmental Care

Sunday, 30 July 2017

Candy Bruton, MSN, RNC-NIC1
Jennifer Meckley, BSN, RNC-NIC1
Lori A. Nelson, BSN, RNC-NIC2
(1)NICU, Texas Health Resources Harris Methodist Hurst-Euless-Bedford, Bedford, TX, USA
(2)Neonatal ICU, Texas Health Harris Methodist Hospital Hurst Euless Bedford, Brdford, TX, USA

The aim of this evidence based practice (EBP) project was to determine how implementing the seven neuroprotective core measures of family-centered developmental care will impact the satisfaction of the NICU nurses through new knowledge, skills and families through partnering with care compared to traditional care. According to the American Academy of Pediatrics (AAP) Committee on Hospital Care and Institute for Family Centered Care policy statement made in 2003 family-centered care is a method in which medical care is grounded in the principle that optimal health outcomes are accomplished when patients’ family members participate in an active role in contributing emotional, social and developmental support (American Academy of Pediatrics, 2003). There is urgency for nursing education and guidance in neuroprotective family-centered developmental care using the seven core measures due to the increase rate of premature birth acquired disability due to being born premature globally (Butler & Als, 2008). Growth continues outside the shielding environment of the uterus and neuroprotective family-centered developmental care creates a healing environment that requires the entire family to partner in the care and growth of their infant (Altimier & Phillips, 2013; Altimer, Kenner & Damus, 2015). Benefits of family-centered care are that families feel more valuable when partnering with nurses in the care of their infant (McGrath, Samra & Kenner, 2011) and feel more empowed when they provide care for their infant. In addition being active participants in developing and maintaining the program increases a sense of fulfillment and nurse satisfaction (Phillps, 2015).

In order to accomplish this, nurses needed a firm understanding of the developmental problems with the high risk and the premature infant. It was critical that this group of caregivers understands the fundamentals of neurosensory growth of these infant. It is also vital that they understand how the intrauterine environment protects the infant from being exposed to the fluctuation of an unstable extrauterine environment.

The Neonatal Integrative Developmental Care Model (NIDCM) was the model we utilized for implementing the seven neuroprotective core measure of family-centered developmental care and are identified as: the healing environment, partnering with families, positioning and handling, minimizing stress and pain, safeguarding sleep, protecting skin and optimizing nutrition. This model is represented by the lotus flower. In the center the first core measure is the healing environments. Each of the remaining six core measures are depicted as overlapping petals to display the integrative nature of developmental care (Altimier, & Phillips, 2013).

The goal of the unit was to empower families by partnering with them to develop proper skills in caring for their infant (Westrup, 2007) positively impacting their stress level, comfort level, and confidence as well as increasing family satisfaction (Cooper, Gooding, Gallagher, Sternesky, Ledsky & Berns, 2007). The goals of the NICU nurses was to gain new knowledge, skills and increase nurse satisfaction by providing developmental care using the seven neuroprotective core measures of family centered-care for every infant every time (Cardin, Rens, Stewart, Danner-Bowman, McCarley & Kopsas, 2015).

The NICU staff was educated on the “Seven Core Measures of Neuroprotective Family-Centered Developmental Care” by lecture, printed education and hands on training with a developmental care specialist. After completion of the training the neuroprotective interventions were implemented on every NICU infant. Parents were give verbal and printed information and educated on the meaning of family centered care.

Conclusion from pre and post surveys that were collected from our NICU nurses showed an increase in knowledge of the appropriate care and potential benefits of these interventions. Pre and post Press-Ganey reports were collected from parents and results showed an increase in satisfaction over most categories. Also the results from parents during discharge phone call surveys showed NICU families had a strong satisfaction with the partnering of care and the level of family centered care their infant received.