改善新生儿重症监护病房中以家庭为中心的婴儿护理：一线医护人员的建议。
Improving Family-Centered Care for Infants in Neonatal Intensive Care Units: Recommendations From Frontline Healthcare Professionals.
作者信息
Franck Linda S, Bisgaard Robin, Cormier Diana M, Hutchison Jennifer, Moore Dishon, Gay Caryl, Christensen Holly, Kriz Rebecca M, Mora Jennifer, Ekno Mary, Hackett Heather, Lare Natasha
机构信息
Department of Family Health Care Nursing, University of California, San Francisco (Drs Franck and Gay); UCSF Benioff Children's Hospital, San Francisco, Intensive Care Nursery, San Francisco, California (Ms Bisgaard and Ms Lare); Community Regional Medical Center, Pediatric Services, Fresno, California (Dr Cormier); UCSF California Preterm Birth Initiative, University of California, San Francisco (Mss Hutchison and Kriz); UCSF Benioff Children's Hospital, Oakland, Intensive Care Nursery, Oakland, California (Mss Moore and Christensen); Intensive Care Nursery, Kaiser Permanente Santa Clara, Santa Clara, California (Ms Mora); UC San Diego Health, Jacobs Medical Center, La Jolla, California (Ms Ekno); and UCLA Health, Santa Monica Medical Center, Intensive Care Nursery Santa Monica, Los Angeles, California (Ms Hackett).
出版信息
Adv Neonatal Care. 2022 Feb 1;22(1):79-86. doi: 10.1097/ANC.0000000000000854.
BACKGROUND
Family-centered care is a philosophy and healthcare delivery model adopted by many neonatal intensive care units (NICUs) worldwide, yet practice varies widely.
PURPOSE
The aim of this study was to synthesize recommendations from frontline NICU healthcare professionals regarding family-centered care.
METHODS
Data were obtained from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care (baseline) with mobile-enhanced family integrated care (intervention). Members of the NICU clinical care team completed a family-centered care survey and provided free-text comments regarding practice of family-centered care in their NICU and recommendations for improvement. The comments were analyzed using a directed content analysis approach by a research team that included NICU nurses and parents.
RESULTS
Of the 382 NICU healthcare providers from 6 NICUs who completed the survey, 68 (18%) provided 89 free-text comments/recommendations about family-centered care. Almost all comments were provided by nurses (91%). Six main themes were identified: language translation; communication between staff and families; staffing and workflow; team culture and leadership; education; and NICU environment. The need for greater resources for staffing, education, and environmental supports was prominent among the comments, as was team culture and staff-parent communications.
IMPLICATIONS FOR PRACTICE
The NICU healthcare professionals identified a range of issues that support or impede delivery of family-centered care and provided actionable recommendations for improvement.
IMPLICATIONS FOR RESEARCH
Future research should include economic analyses that will enable determination of the return on investment so that NICUs can better justify the human and capital resources needed to implement high-quality family-centered care.
背景
以家庭为中心的护理是一种理念和医疗服务模式，被全球许多新生儿重症监护病房（NICU）所采用，但实际做法差异很大。
目的
本研究旨在综合一线NICU医护人员关于以家庭为中心护理的建议。
方法
数据来自一项多中心准实验研究的基线阶段，该研究将常规的以家庭为中心的NICU护理（基线）与移动增强型家庭综合护理（干预）进行比较。NICU临床护理团队成员完成了一项以家庭为中心护理的调查，并就其所在NICU以家庭为中心护理的实践情况及改进建议提供了自由文本评论。由包括NICU护士和家长在内的研究团队采用定向内容分析法对这些评论进行分析。
结果
来自6个NICU的382名NICU医护人员完成了调查，其中68人（18%）提供了89条关于以家庭为中心护理的自由文本评论/建议。几乎所有评论均由护士提供（91%）。确定了六个主要主题：语言翻译；医护人员与家庭之间的沟通；人员配备与工作流程；团队文化与领导力；教育；以及NICU环境。评论中突出强调了需要为人员配备、教育和环境支持提供更多资源，团队文化以及医护人员与家长之间的沟通也是如此。
对实践的启示
NICU医护人员确定了一系列支持或阻碍以家庭为中心护理实施的问题，并提供了可采取行动的改进建议。
对研究的启示
未来的研究应包括经济分析，以便能够确定投资回报率，从而使NICU能够更好地证明实施高质量以家庭为中心护理所需的人力和资本资源的合理性。
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