Dunn Michael S, Reilly Maureen C, Johnston Anne M, Hoopes Robert D, Abraham Marie R
Sunnybrook and Women's College Health Sciences Centre and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Pediatrics. 2006 Nov;118 Suppl 2:S95-107. doi: 10.1542/peds.2006-0913F.
Family-centered care has become integral to the provision of quality neonatal intensive care. However, practices that reflect the core principles of family-centered care have not been described fully in the literature or implemented and evaluated consistently within newborn intensive care. The objective of this study was to create a family-centered care map that enhances the ability of the health care team to work with families to coordinate and deliver care in a holistic manner to meet the developmental, physical, and psychosocial needs of NICU patients and their families.
Potentially better practices were developed for sequential clinical phases by using standardized methods. These included focus groups with families, brainstorming sessions with staff, literature review, and input from established family advisory groups and family-centered care experts. Potentially better practices then were integrated into the family-centered care map that was configured in a Web-based format. Overall utility will be evaluated by determining the effect of the family-centered care map on length of stay, parental satisfaction, and family-centered care beliefs and practices among NICU staff.
Sixty-three potentially better practices were identified for 7 clinical phases and 3 variations that were believed to characterize the clinical course of a typical NICU patient. A prototype of the Web-based family-centered care map that illustrates the clinical phases with links to the related potentially better practices, operational processes, and case studies was created. Baseline data from a care provider survey, from a family satisfaction survey, and on length of stay have been collected.
Quality improvement methods and collaboration among 3 centers led to the development of an innovative Web-based resource to assist individual care providers and family advisors to provide comprehensive family-centered care to infants and families. Implementation of the family-centered care map has potential to affect positively the quality of newborn intensive care and lead to improved long-term outcomes.
以家庭为中心的护理已成为提供优质新生儿重症监护不可或缺的一部分。然而，体现以家庭为中心护理核心原则的实践在文献中并未得到充分描述，在新生儿重症监护中也未得到一致的实施和评估。本研究的目的是创建一个以家庭为中心的护理地图，以提高医疗团队与家庭合作的能力，以整体方式协调和提供护理，满足新生儿重症监护病房（NICU）患者及其家庭的发育、身体和心理社会需求。
通过使用标准化方法，为连续的临床阶段制定了可能更好的实践。这些方法包括与家庭进行焦点小组讨论、与工作人员进行头脑风暴会议、文献综述，以及来自既定家庭咨询小组和以家庭为中心护理专家的意见。然后，将可能更好的实践整合到以网络为基础的以家庭为中心的护理地图中。将通过确定以家庭为中心的护理地图对住院时间、家长满意度以及NICU工作人员的以家庭为中心护理信念和实践的影响来评估其总体效用。
针对7个临床阶段确定了63种可能更好的实践以及3种变异情况，这些被认为是典型NICU患者临床过程的特征。创建了一个基于网络的以家庭为中心的护理地图原型，该地图展示了临床阶段，并链接到相关的可能更好的实践、操作流程和案例研究。已收集了来自护理提供者调查、家庭满意度调查的基线数据以及住院时间数据。
三个中心之间的质量改进方法和合作促成了一种创新的基于网络的资源的开发，以协助个体护理提供者和家庭顾问为婴儿及其家庭提供全面的以家庭为中心的护理。实施以家庭为中心的护理地图有可能对新生儿重症监护质量产生积极影响，并带来更好的长期结果。
