Published by: Dr Jemila James

Published Date: 11/17/2024

World Prematurity Day 2024

Parent Participation in quality care:

On this World Prematurity Day, 17 November 2024, we emphasize the role of parental involvement in providing a quality care to their sick and premature babies.
The translation and adaptation process of parental involvement in decision making and caring sick babies in improving quality care is achieved through Family Centered Care [FCC] model, in addition to the conventional model of care provided by the physician and nurses.
FCC model, address the unmet psychosocial needs of the family and developmental needs of the sick neonate by recognizing the family as an integral part of the care team and promoting the parental involvement in caregiving throughout the period of hospitalization and working with families to facilitate the discharge process; so that, parents emerge from the neonatal intensive care unit (NICUs)/Special Care Newborn Units (SCNUs) experience with better care-giving competencies.
The practice of FCC is likely to be the cornerstone of continuum of quality care, imparting caregiving competencies to parents/caregivers both within the institutions as well as after the discharge.

What is Family Centered Care [FCC] model?

Aim of the FCC model is to promote and nurture a unique milieu in the neonatal intensive care unit by actively involving parents in caregiving to their babies.
FCC creates an environment that is responsive to the family-identified needs; culturally sensitive; and above all, provides a setting in which family is empowered and encouraged to support care for their baby as the constant caretaker from admission onward until discharge.
This also prepares them for better handling and care of the baby at home after discharge.

Challenges in implementing FCC in the Neonatal intensive care unit [NICU]:

Parental Emotional Strain: Parents often experience stress, grief or anxiety, which can complicate their participation in care.
Cultural Differences: Different cultural views on family involvement and health care can create barriers to effective FCC.
Physical and logistical barriers: Limited space, visitation policies and the complexity of neonatal care may limit family access.
Time & Staffing Constraints: NICU staff may face time pressures and difficulty in balancing patient care and family involvement.
Challenges for health care providers: Training and teaching the parents in hand-washing skills, certain care giving procedures – like providing basic nursing and developmentally supportive care to their babies, keeping their babies warm, technique of breast feeding and assisted feeding, Kangaroo Mother Care (KMC), preparation for discharge and recognition of danger signs

Evidence based FCC Outcomes:

Currently, the practice of FCC is being widely accepted and practiced across neonatal intensive care units for a range of advantages that it provides.
Favourable outcomes pertain to all three stakeholders namely:
        the baby (patient),
        the family and
        the neonatal intensive care staffs
The positive impact on the sick and premature neonate has been evident from better weight gain, shorter length of hospital stays, and higher breast-feeding rates before hospital discharge. In addition, parent holding is related to better neurobehavior at term equivalent age and better developmental outcomes at 4-5yrs, which highlights the importance of engaging families in the neonatal intensive care unit (NICU).
Impact on the family has been observed in the form of better informed and confident parents who are able to cope better with stress or fear and altered parenting roles. All this culminates in overall better family satisfaction with the health care experience. There is enhanced bonding between the parents and their baby and an ease of transfer from hospital to home.
Because of work sharing, the impact on the neonatal intensive care staff, in terms of delivery of better quality of care with better staff satisfaction and a positive impact on stress levels. In addition, this has been shown to be associated with better allocation of human resources.
To conclude, through respectful participation and engagement in non-medical aspects of care for the newborn, families and health care providers form a collaboration/therapeutic alliance based on improved communication, transparency, accountability and integrity. The result is a win-win situation for all stakeholders.

“In the NICU, the strength of the family is an essential part of the healing process”.

Published by

Dr Jemila James

Consultant in Neonatology

Dr. Jemila James has over 24 years of experience in the field of Pediatrics & Neonatology. She has been focusing and practicing Neonatal care for the last 12 years.

With qualifications in Neonatology and Pediatrics, from reputed insititues such as CMC (Christian Medical College), Vellore, India, she is the hospital's Consultant Neonatologist.

Link to : Neonatology Department