Bonner Oliver, Beardsall Kathryn, Crilly Nathan, Lasenby Joan
Department of Engineering , University of Cambridge , Cambridge , UK.
Cambridge University Hospitals NHS Trust , Cambridge , UK.
BMJ Innov. 2017 Feb;3(1):12-18. doi: 10.1136/bmjinnov-2016-000145. Epub 2017 Jan 4.
The neonatal intensive care unit (NICU) can be one of the most stressful hospital environments. Alongside providing intensive clinical care, it is important that parents have the opportunity for regular physical contact with their babies because the neonatal period is critical for parent-child bonding. At present, monitoring technology in the NICU requires multiple wired sensors to track each baby's vital signs. This study describes the experiences that parents and nurses have with the current monitoring methods, and reports on their responses to the concept of a wireless monitoring system.
Semistructured interviews were conducted with six parents, each of whom had babies on the unit, and seven nurses who cared for those babies. The interviews initially focused on the participants' experiences of the current wired system and then on their responses to the concept of a wireless system. The transcripts were analysed using a general inductive approach to identify relevant themes.
Participants reported on physical and psychological barriers to parental care, the ways in which the current system obstructed the efficient delivery of clinical care and the perceived benefits and risks of a wireless system. The parents and nurses identified that the wires impeded baby-parent bonding; physically and psychologically. While a wireless system was viewed as potentially enabling greater interaction, staff and parents highlighted potential concerns, including the size, weight and battery life of any new device.
The many wires required to safely monitor babies within the NICU creates a negative environment for parents at a critical developmental period, in terms of physical and psychological interactions. Nurses also experience challenges with the existing system, which could negatively impact the clinical care delivery. Developing a wireless system could overcome these barriers, but there remain challenges in designing a device suitable for this unique environment.
新生儿重症监护病房(NICU)可能是医院里压力最大的环境之一。除了提供重症临床护理外,让父母有机会定期与婴儿进行身体接触也很重要,因为新生儿期对亲子关系的建立至关重要。目前,NICU中的监测技术需要多个有线传感器来跟踪每个婴儿的生命体征。本研究描述了父母和护士对当前监测方法的体验,并报告了他们对无线监测系统概念的反应。
对六名在该病房有婴儿的父母和七名照顾这些婴儿的护士进行了半结构化访谈。访谈最初聚焦于参与者对当前有线系统的体验,然后是他们对无线系统概念的反应。使用一般归纳法对访谈记录进行分析,以确定相关主题。
参与者报告了父母护理方面的身体和心理障碍、当前系统阻碍临床护理高效提供的方式以及无线系统的感知益处和风险。父母和护士发现,电线在身体和心理上都阻碍了亲子关系的建立。虽然无线系统被认为可能会促进更多互动,但工作人员和父母强调了潜在的担忧,包括任何新设备的尺寸、重量和电池寿命。
在NICU中安全监测婴儿所需的众多电线,在身体和心理互动方面,为处于关键发育阶段的父母营造了一个负面环境。护士在现有系统中也面临挑战,这可能会对临床护理的提供产生负面影响。开发无线系统可以克服这些障碍,但在设计适合这种独特环境的设备方面仍存在挑战。