269 - Evaluating the Culture of Family-Centered Care in the NICU

Poster Number: 269
Publication Number: 269.131

Sophia G. Strine, Ann & Robert H. Lurie Children's Hospital of Chicago, Swarthmore, PA, United States; Kerri Machut, Northwestern University The Feinberg School of Medicine, Evanston, IL, United States; Katherine Bean, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Susan Horner, Ann & Robert H. Lurie Children's Hospital of Chicago, Lombard, IL, United States; Ya Tuo, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Stella W. Karuri, Stanley Manne Children's Research Institute, Chicago, IL, United States; Jessica T. Fry, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Family-centered care (FCC) in neonatal intensive care units (NICUs) has been shown to improve parent engagement and neonatal outcomes. However, family-centered care is not standardized within and across NICUs, leading to variation in institutional practices. NICUs likely develop unique local “cultures” related to FCC, meaning shared ways of thinking, feeling, and acting among NICU staff which may affect patient and family care.

Objective: To describe parental and staff perspectives on the quality of family centered-care culture in a NICU.

Design/Methods: Parents of hospitalized NICU infants and staff at a large, urban referral NICU completed a validated survey tool (Digi-FCC), designed to measure the quality of NICU FCC through 8 questions on topics such as trust, communication, and shared decision making. Respondents rated topics on a Likert scale from 1 (most negative) to 7 (most positive). Parents were asked to complete the study tool based upon their experience on the day of completion. Staff responded by reflecting on their past 2 work weeks. We collected parent and staff demographic information and infant clinical variables. We compared parent and staff responses to each survey question using a cumulative log-odds model.

Results:

68 parents of 54 NICU infants and 73 NICU providers completed the survey tool at least once. Participant and infant characteristics are in Table 1. The majority of parent and staff participants rated all items highly, indicating good experiences with unit-based 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 was listening to parents (97.3%). Receiving/providing emotional support received the lowest scores for parents (19.1% negative or neutral) and staff (24.6%). Parent and staff answers differed significantly for 6 of 8 questions (Figure 1), with lower median scores of staff relative to parents.

Conclusion(s): Though it may seem difficult to measure a local “culture” related to FCC, parents of hospitalized NICU infants and NICU staff provided real time feedback on the quality of FCC provided. Differences observed between parent and staff surveys indicate staff have slightly more negative perspectives on providing FCC than parents report receiving. Targeted staff interventions and support may strengthen FCC for NICU patients and parents. Future directions include assessing FCC quality over time and for specific patient, parent, and staff cohorts.