Impact of Increased Parent Presence in the Neonatal Intensive Care Unit on Parent & Infant Outcomes

Family centered care (FCC) is becoming the standard of care in the Neonatal Intensive Care
Unit (NICU) and many benefits of FCC programs are reported in the literature. However, the
integration of FCC practices remains inconsistent in NICUs and many families do not fully
access available FCC supports. As a result NICU families continue to report feelings of
powerlessness, stress, depression and lack of confidence in their ability to care for their
infants at home. Studies of increased family presence in the NICU (8hours/day and
24/hours/day) have reported promising results for infants and families, but these studies
report on programs implemented outside of the US. It is not known whether a program requiring
fewer hours/day of parent presence, which may be a better fit with current US family
demographics and policies, would demonstrate similar benefits. The purpose of this pilot
study is to compare parent and infant outcomes and unit outcomes pre and post a planned
unit-wide intervention aimed at increasing parent presence in the NICU. The FCC intervention
will consist of communicating an expectation that all NICU parents be present at minimum 4
hours/day versus the current practice of telling families to "come as much as they can" that
has resulted in inconsistent parent presence. Following informed consent, data will be
collected on up to 45 NICU infants and families pre- and post- the intervention for a total
sample of up to 90. Infant measures will include Salivary Cortisol levels, Infant weight
gain, Length of Stay and Feeding route at discharge as well as rates of Family Visiting,
Traditional Holding, Kangaroo Care (KC), and Breastfeeding. Parent measures will include
Salivary Cortisol Levels and reported stress using the Parent Stress Scale: NICU. Unit-wide
data will also be collected pre- and post- the intervention. Unit wide measures will include
rates of Visitation, KC, Breastfeeding, Nosocomial Infections, IV infiltrates, Medication
Errors and Incident (SERS) report rates.

Inclusion Criteria:

- Less than 2 weeks of age

- Must be admitted to NICU

Exclusion Criteria:

- Previously discharged home

- <28 weeks gestation

- Anticipated hospital stay > 3 months