Department of Pediatrics, University of California Davis, Sacramento, Calif.
Department of Pediatrics, University of California Davis, Sacramento, Calif.
Acad Pediatr. 2021 Sep-Oct;21(7):1244-1252. doi: 10.1016/j.acap.2021.03.007. Epub 2021 Mar 18.
To measure the feasibility, reach, and potential impact of a virtual family-centered rounds (FCR) intervention in the neonatal intensive care unit.
We conducted a randomized controlled pilot trial with a 2:1 intervention-to-control arm allocation ratio. Caregivers of intervention arm neonates were invited to participate in virtual FCR plus standard of care. We specified 5 feasibility objectives. We profiled intervention usage by neonatal and maternal characteristics. Exploratory outcomes included FCR caregiver attendance, length of stay, breast milk feeding at discharge, caregiver experience, and medical errors. We performed descriptive analyses to calculate proportions, means, and rates with 95% confidence intervals (CI).
We included 74 intervention and 36 control subjects. Three of the five feasibility objectives were met based on the point estimates. The recruitment and intervention uptake objectives were not achieved. Among intervention arm subjects, recruitment of a caregiver occurred for 47 (63.5%, 95% CI 51.5%-74.4%) neonates. Caregiver use of the intervention occurred for 36 (48.6%, 95% CI 36.8%-60.6%) neonates in the intervention arm. Feasibility objectives assessing technical issues, burden, and data collection were achieved. Among the attempted virtual encounters, 95.0% (95% CI 91.5%-97.3%) had no technical issues. The survey response rate was 87.5% (95% CI 78.2%-93.8%). Intervention arm neonates had 3.36 (95% CI 2.66%-4.23) times the FCR caregiver attendance rate of subjects in the control arm.
A randomized trial to compare virtual FCR to standard of care in neonatal subjects is feasible and has potential to improve patient and caregiver outcomes.
测量新生儿重症监护病房中虚拟家庭为中心的查房(FCR)干预的可行性、可及性和潜在影响。
我们进行了一项随机对照试点试验,干预组与对照组的分配比例为 2:1。邀请干预组新生儿的照顾者参加虚拟 FCR 加标准护理。我们规定了 5 个可行性目标。我们根据新生儿和产妇的特点描述干预措施的使用情况。探索性结果包括 FCR 照顾者的出席率、住院时间、出院时母乳喂养情况、照顾者体验和医疗错误。我们进行了描述性分析,计算了比例、平均值和 95%置信区间(CI)的率。
我们纳入了 74 名干预组和 36 名对照组的受试者。根据点估计,有 3 个可行性目标达到了。招募和干预参与的目标没有实现。在干预组的受试者中,有 47 名(63.5%,95%CI 51.5%-74.4%)新生儿的照顾者参与了招募。在干预组中,有 36 名(48.6%,95%CI 36.8%-60.6%)新生儿的照顾者使用了干预措施。评估技术问题、负担和数据收集的可行性目标得到了实现。在尝试的虚拟会面中,95.0%(95%CI 91.5%-97.3%)没有技术问题。调查的回复率为 87.5%(95%CI 78.2%-93.8%)。干预组新生儿的 FCR 照顾者出席率是对照组的 3.36 倍(95%CI 2.66%-4.23)。
一项比较新生儿虚拟 FCR 与标准护理的随机试验是可行的,并有潜力改善患者和照顾者的结局。