Hallowell Sunny G, Rogowski Jeannette A, Lake Eileen T
Villanova University College of Nursing, Villanova, Pennsylvania (Dr Hallowell); Institute for Health, Health Care Policy and Aging Research, School of Public Health, Rutgers, The State University of New Jersey, New Brunswick (Dr Rogowski); and Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia (Dr Lake).
Adv Neonatal Care. 2019 Feb;19(1):65-72. doi: 10.1097/ANC.0000000000000431.
Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants.
To examine the relationship between the NICU work environment and parental presence in the NICU using a national data set.
We conducted a cross-sectional, observational study of a national sample of 104 NICUs, where 6060 nurses reported on 15,233 infants cared for. Secondary analysis was used to examine associations between the Practice Environment Scale of the Nursing Work Index (PES-NWI) (subscale items and with a composite measure) and the proportion of parents who were present during the nurses' shift.
Parents of 60% (SD = 9.7%) of infants were present during the nurses' shift. The PES-NWI composite score and 2 domains-Nurse Participation in Hospital Affairs and Manager Leadership and Support-were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present.
Parental presence in the NICU is significantly associated with better nurse work environments. NICU practices may be enhanced through enhanced leadership and professional opportunities for nurse managers and staff.
Future work may benefit from qualitative work with parents to illuminate their experiences with nursing leaders and nurse-led interventions in the NICU and design and testing of interventions to improve the NICU work environment.
新生儿重症监护病房（NICU）中父母的陪伴对于家庭参与婴儿护理并为他们从医院过渡到家庭做好准备至关重要。护士是NICU的主要护理人员。护士的工作环境可能会影响父母是否有时间陪伴住院的婴儿。
使用全国数据集研究NICU工作环境与父母在NICU陪伴之间的关系。
我们对全国104个NICU的样本进行了横断面观察性研究，6060名护士报告了他们护理的15233名婴儿的情况。采用二次分析来检验护理工作指数实践环境量表（PES-NWI）（子量表项目和综合测量）与护士轮班期间父母陪伴比例之间的关联。
在护士轮班期间，60%（标准差 = 9.7%）的婴儿有父母陪伴。PES-NWI综合得分以及两个领域——护士参与医院事务和管理者领导力与支持——是父母陪伴的重要预测因素。综合得分或任何一个子量表得分每高出1个标准差，父母陪伴的比例就会增加2.5%。
NICU中父母的陪伴与更好的护士工作环境显著相关。可以通过加强对护士管理者和工作人员的领导力和专业机会来改善NICU的实践。
未来的研究可能会从与父母的定性研究中受益，以阐明他们在NICU与护理领导者和由护士主导的干预措施的经历，以及设计和测试改善NICU工作环境的干预措施。
