Ottosen Madelene J, Engebretson Joan, Etchegaray Jason, Arnold Cody, Thomas Eric J
Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston (Drs Ottosen and Engebretson); Senior Biobehavioral Scientist, RAND Corporation, Santa Monica, California (Dr Etchegaray); Department of Neonatology, McGovern Medical School, The University of Texas Health Science Center at Houston (Dr Arnold); and Department of Internal Medicine, The University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, McGovern Medical School, The University of Texas Health Science Center at Houston (Dr Thomas).
Adv Neonatal Care. 2019 Dec;19(6):500-508. doi: 10.1097/ANC.0000000000000657.
Parents of neonates are integral components of patient safety in the neonatal intensive care unit (NICU), yet their views are often not considered. By understanding how parents perceive patient safety in the NICU, clinicians can identify appropriate parent-centered strategies to involve them in promoting safe care for their infants.
To determine how parents of neonates conceptualize patient safety in the NICU.
We conducted qualitative interviews with 22 English-speaking parents of neonates from the NICU and observations of various parent interactions within the NICU over several months. Data were analyzed using thematic content analysis. Findings were critically reviewed through peer debriefing.
Parents perceived safe care through their observations of clinicians being present, intentional, and respectful when adhering to safety practices, interacting with their infant, and communicating with parents in the NICU. They described partnering with clinicians to promote safe care for their infants and factors impacting that partnership. We cultivated a conceptual model highlighting how parent-clinician partnerships can be a core element to promoting NICU patient safety.
Parents' observations of clinician behavior affect their perceptions of safe care for their infants. Assessing what parents observe can be essential to building a partnership of trust between clinicians and parents and promoting safer care in the NICU.
Uncertainty remains about how to measure parent perceptions of safe care, the level at which the clinician-parent partnership affects patient safety, and whether parents' presence and involvement with their infants in the NICU improve patient safety.
新生儿的父母是新生儿重症监护病房（NICU）患者安全的重要组成部分，但他们的观点往往未被考虑。通过了解父母如何看待NICU中的患者安全，临床医生可以确定适当的以父母为中心的策略，让他们参与到促进对其婴儿的安全护理中来。
确定新生儿父母如何理解NICU中的患者安全。
我们对来自NICU的22位说英语的新生儿父母进行了定性访谈，并在几个月内观察了NICU内父母的各种互动情况。使用主题内容分析法对数据进行分析。通过同行汇报对研究结果进行严格审查。
父母通过观察临床医生在遵守安全规范、与婴儿互动以及在NICU与父母沟通时的在场、用心和尊重，感受到了安全护理。他们描述了与临床医生合作以促进对其婴儿的安全护理以及影响这种合作关系的因素。我们构建了一个概念模型，突出了父母与临床医生的合作关系如何能够成为促进NICU患者安全的核心要素。
父母对临床医生行为的观察会影响他们对其婴儿安全护理的认知。评估父母的观察情况对于建立临床医生与父母之间的信任合作关系以及促进NICU更安全的护理至关重要。
关于如何衡量父母对安全护理的认知、临床医生与父母的合作关系对患者安全的影响程度，以及父母在NICU陪伴和参与照顾婴儿是否能提高患者安全，仍存在不确定性。
