Culture of Family-Centered Care in the NICU.

Abstract

Background: Family centered-care (FCC) has documented benefits for infants, parents, and staff, but is variably practiced.

Purpose: To describe parental and staff perspectives on the quality of FCC culture in a neonatal intensive care unit (NICU).

Methods: Parents of hospitalized infants and staff at a referral NICU completed validated survey instruments to measure NICU FCC quality on topics including trust, communication, and shared decision-making at multiple time points. We compared parent and staff responses using a cumulative log-odds model with a single predictor to model the odds of a score lower than a prespecified value.

Results: A total of 92 parents of 80 NICU infants and 96 NICU providers participated. Most rated items highly, indicating a positive experience with FCC. The items with the highest scores for parents were receiving guidance and being trusted in their infant's care (both 97.1% positive); for staff, listening to parents (95%). Receiving/providing emotional support received the lowest scores from parents (19.1% negative or neutral) and staff (24.5%). Parent and staff answers differed significantly for 6 of 8 questions, with lower scores reported by staff relative to parents.

Implications for practice and research: Parents and staff have variable perspectives on different aspects of FCC. Understanding these nuances of centers' FCC culture can help target interventions and may strengthen FCC delivery for NICU infants and families and career satisfaction for staff. Future directions include assessing FCC quality over time and among specific infant, family, and staff cohorts, especially diverse populations to determine if FCC is equitably delivered.