Implementing an open unit policy in a neonatal intensive care unit: nurses' and parents' perceptions.

Abstract

Family presence is linked to reduced stress, better patient safety, and increased family satisfaction. But parental presence can increase nurses' workload and make nurses feel uncomfortable. An open unit (OU) policy and plan for implementation was developed. An anonymous survey was given to nurses about an OU pre- and postimplementation. Responses were used to learn perceived barriers; focus groups were held to understand the concerns and develop solutions. The success of the program was measured by pre/post nursing and parent surveys. Initially, 87% (76/87) of nurses were not in favor of an OU. Most common concerns were as follows: HIPPA 71%, social issues 56%, and increased time for report 45%. Post-OU, only 17% (10/59) were not in favor. Fifty-four percent expressed no major concerns. The most common concerns were as follows: interruptions 25%, limited space 22%, HIPPA 17%. Eighty percent cited benefits for parents. Most common benefits were as follows: increased visiting 49% and improved parent emotional state 43%. Pre-OU, 78% (18/23) of parents felt they were allowed to be with their baby as much as they wanted compared to 92% (36/39) post-OU. Neonatal intensive care unit nurses had reservations toward open visitation, but with education and a focused process for implementation, most nurses favored the change and benefits for families were recognized. Parent satisfaction increased regarding time spent with their infant.