Providing comprehensive family support should be a top priority in every NICU to help parents cope with the stressful experience of having a sick or premature baby. Doing so requires implementation of the “Recommendations for Psychosocial Support of NICU Parents” (Hall & Hynan, 2015) to the greatest degree possible. These recommendations cover best practices in the areas of providing emotional support to parents; communicating with parents; providing family-centered developmental care, peer-to-peer support, and palliative and bereavement care; planning for discharge and beyond; and supporting staff while they support families.

One approach to improving a NICU’s practices relating to family support was described in the article “Transforming NICU Care to Provide Comprehensive Family Support” (Hall, Hynan & Phillips, 2016). This outlined how a multidisciplinary staff team could utilize a NICU Self-Assessment Tool to target specific projects to work on. Examples were presented in each of the recommendations’ content areas.

Another “tool” has now become available to improve staff’s ability to support parents and families: an online continuing education course, which fills a crucial gap in providers’ education based on the recommendations, called “Caring for Babies and Their Families: Providing Psychosocial Support in the NICU.” My NICU Network (at www.mynicunetwork.com) was created by a multidisciplinary collaboration of professionals and NICU graduate parents from three organizations (National Perinatal Association, Patient + Family Care, NICU Parent Network) to develop and provide this online course. The course is made up of seven one-hour modules on the topics listed above; content is evidence-based, story-driven, clinically relevant, trauma-informed, and resource rich. A key aspect is that it was co-developed in partnership with NICU parents, which is strongly reflected in the content with its many parent stories and audio and video clips from parents to illustrate learning points. It also features a discussion board where participants can comment on the various ideas presented and discuss them with each other and with course instructors, which include a NICU nurse and a parent.

This course can be incorporated into a broader quality improvement initiative by having all staff from a NICU take it at the same time. The idea is for the staff to work together to transform their unit culture from being baby-focused to adopting a broader family focus. The NICU team would benefit from doing the NICU Self-Assessment prior to taking the course to identify areas that need improvement, and to again discuss the Self-Assessment after taking the course to solidify choices for improvement projects and to incorporate ideas and resources presented in the course into their project plans. The self-assessment can be used as an ongoing tool to periodically appraise progress towards achieving the goal of providing comprehensive family support in the NICU.

Preliminary (unpublished) data analyzing the course’s efficacy in improving providers’ knowledge and attitudes towards providing psychosocial support to parents and families is now available. Ninety-seven NICU staff at two institutions (St. John’s Regional Medical Center in Oxnard, CA; University of Mississippi Medical Center in Jackson, MS) participated in a study evaluating pre/posttest comparisons on items relating to course content. Of these, 88% were nurses. NICU staff were aware of the importance of their role in reducing parental trauma during the NICU experience, but on average only “somewhat agreed” that they had the appropriate skills to do so prior to taking the course. Of the 32 participants who completed the pretest and some or all the posttests, statistically significant improvements were demonstrated in 22/32 (69%) of items. In addition, the majority of staff (greater than 75% in each case) “agreed” or “strongly agreed” that taking the course improved their knowledge and would change their practice, and that they would recommend the course to their peers.

And finally, yet another “tool” for improving family support is an online portal for NICU parent education provided by The Wellness Network, called Your NICU Baby  This resource, which can be accessed 24/7/365 by parents on a tablet, computer, or smart phone, and can serve as a valuable supplement to the NICU staff’s own parent education efforts. Its more than 40 short educational videos and numerous educational handouts, which can be downloaded, cover a broad range of topics from orientation to the NICU and its staff, to infection control procedures, breast feeding, baby care, and medical diagnoses as well as parent experiences.

Embracing both NICU staff education and parent education together can create a powerful platform for moving your NICU forward in the quest to provide comprehensive family support, especially when done in the context of a broad quality improvement initiative. Use this NICU Self-Assessment Tool to gauge how your NICU ranks in providing comprehensive support to your patients and their families.


Resources

  1. Hall, SL, and MT Hynan, eds. 2015. “Interdisciplinary Recommendations for the Psychosocial Support of NICU Parents.” Journal of Perinatology 35: Supplement.
  2. Hall, SL, MT Hynan, and R Phillips. 2016. “Transforming NICU Care to Provide Comprehensive Family Support.” Newborn and Infant Nursing Reviews 16: 69–73. https://doi.org/doi:10.1053/j.nainr.2016.03.008.